Screening Verification

National Household Survey on Behavioral Health (NHSBH)

Documents and Forms

Document Name Document Type
Form 2025 CATI Verifica Screening Verification Form and Instruction
2025 CATI Verifica 2025 CATI Verification Scripts Attachment V_CATI Verification Scripts_2025.pdf Form and Instruction
2025 CATI Verifica 2025 CATI Verification Scripts Attachment V_CATI Verification Scripts_2025_Final 9-30-24.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Screening Verification	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	2025 CATI Verification Scripts	2025 CATI Verification Scripts	Attachment V_CATI Verification Scripts_2025_Final 9-30-24.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Alcohol, Drug Abuse, and Mental Health Epidemiologic Data (HHS/SAMHSA/OA)	FR Citation: 84 FR 27341

Number of Respondents: 6,004	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	6,004	1,936	4,068
Annual IC Time Burden (Hours)	402	129	273
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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