Developmental Projects & Special Studies Testing

[NCHS] National Health and Nutrition Examination Survey (NHANES)

Documents and Forms

Document Name Document Type
Form 0920-0950 Developmental Projects & Special Studies Testing Form and Instruction
Att_16_Spec_Studies 2022OCT13.docx Other-Examples of Potential Special
0920-0950 Introductory Letter for SP Questionnaire Att_13a_Introductory Letter for SP Questionnaire 2022OCT13.docx Form and Instruction
0920-0950 Introductory Letter for SP Questionnaire Att_13a_Introductory Letter for SP Questionnaire 2022OCT13.docx Form and Instruction
0920-0950 NHANES Follow-Up Questionnaire Att_3f2_NHANES_Follow_up_Questionnaire_v9_2022OCT13.pdf Form and Instruction
0920-0950 NHANES Follow-Up Questionnaire Att_3f2_NHANES_Follow_up_Questionnaire_v9_2022OCT13.pdf Form and Instruction
0920-0950 NHANES Refuser No Show Questionnaire Att_3f4_NHANES_Refuser_No_Show_v8_02022OCT13.pdf Form and Instruction
0920-0950 NHANES Refuser No Show Questionnaire Att_3f4_NHANES_Refuser_No_Show_v8_02022OCT13.pdf Form and Instruction
Att_3f1_MEC FollowUp_Letter_2022OCT13.docx MEC Follow-Up Letter IC Document
Att_3f1_MEC FollowUp_Letter_2022OCT13.docx MEC Follow-Up Letter IC Document
Att_3f3_MEC Refusers_Letter_2022OCT13.docx MEC Refuser Letter IC Document
Att_3f3_MEC Refusers_Letter_2022OCT13.docx MEC Refuser Letter IC Document

Information Collection (IC) Details

IC Title:	Developmental Projects & Special Studies Testing	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-0950	Introductory Letter for SP Questionnaire	Att_13a_Introductory Letter for SP Questionnaire 2022OCT13.docx		Yes	Yes	Fillable Fileable
Form and Instruction	0920-0950	NHANES Follow-Up Questionnaire	Att_3f2_NHANES_Follow_up_Questionnaire_v9_2022OCT13.pdf	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-0950	NHANES Refuser No Show Questionnaire	Att_3f4_NHANES_Refuser_No_Show_v8_02022OCT13.pdf	NA	Yes	Yes	Fillable Fileable
Other-Examples of Potential Special Studies			Att_16_Spec_Studies 2022OCT13.docx		Yes	Yes	Fillable Fileable

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: 3,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,500	3,500
Annual IC Time Burden (Hours)	10,500	10,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
MEC Follow-Up Letter	Att_3f1_MEC FollowUp_Letter_2022OCT13.docx	03/06/2023
MEC Refuser Letter	Att_3f3_MEC Refusers_Letter_2022OCT13.docx	03/06/2023

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