Information Collection

[NCHS] Health Data User Survey 2023

IC 259883 under ICR 202301-0920-017 · OMB 0920-0729.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Health Data User Survey [NCHS] Health Data User Survey 2023	Form
1 Health Data User Survey Health Data User Survey 2023 050423 Clean NCHS.docx	Form
SSA Health Data User Survey_04262023.docx Supporting Statement Part A	IC Document
Sup St B 08132020 Health Data User Survey for OMB_042123.docx Supporting Statement Part B	IC Document

IC Title:

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1				Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: 09-20-0164 Health and Demographic Surveys Conducted in Probability Samples of the U.S. Population

FR Citation: 49 FR 37693

Number of Respondents: 750

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	750	750
Annual IC Time Burden (Hours)	63	63
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement Part A		04/26/2023
Supporting Statement Part B		04/26/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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