Household Screening

National Survey on Drug Use and Health (NSDUH)

Documents and Forms

Document Name Document Type
Form In-Person Screenin Household Screening Form and Instruction
In-Person Screenin In-Person Screening Questions Attachment T_In-Person Screening Questions_Final 9-30-24.pdf Form and Instruction
Web-based Screenin Web-based Screening Questions Attachment WEB-6_Web-based Screening Questions_Final 9-30-24.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Household Screening	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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	In-Person Screening Questions	In-Person Screening Questions	Attachment T_In-Person Screening Questions_Final 9-30-24.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	Web-based Screening Questions	Web-based Screening Questions	Attachment WEB-6_Web-based Screening Questions_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: 285,894	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	285,894	285,894
Annual IC Time Burden (Hours)	23,729	23,729
Annual IC Cost Burden (Dollars)	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.