OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

[nchs] Ccqder - Nisvs

IC 263924 under ICR 202504-0920-019 · OMB 0920-0222.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form
Form
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

[NCHS] CCQDER - NISVS 0920-0222-24BR
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0222 NISVS Screener Attachment 4_Screener_NISVS TBI.docx NA Yes Yes Fillable Fileable
Form and Instruction 0920-0222 NISVS Questionnaire Attachment 1_Questions to test.docx NA No   Paper Only
Form 0920-0222 {NISVS] Respondent Data Collection Sheet (No Form) Respondent Data Collection Sheet - NISVS.docx NA No   Paper Only

Health Public Health Monitoring

Health and Demographic Surveys Conducted in Probability Samples of the U. S. Population 09-20-0164  49 FR 37693

80 0
   
Individuals or Households
 
   0 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 80 0 0 0 0 80
Annual IC Time Burden (Hours) 23 0 0 0 0 23
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
NISVS - Previous Use and Development Attachment 2- Previous Use and Development.docx 12/19/2023
NISVS/TBI - Advertisement Attachment 3- Advertisement_NISVS TBI.docx 12/19/2023
NISVS/TBI - Informed Consent Attachment 5_Informed Consent_NISVS TBI 12.5.23.docx 12/19/2023
NISVS/TBI - Respondent Distress Guide Attachment 6 -Respondent Distress guide.docx 12/19/2023
NISVS/TBI - Interviewer Distress Guide Attachment 7-Interviewer Distress Guidance_.docx 12/19/2023
NISVS/TBI - Secondary Trauma Training Attachment 8-Secondary Trauma Training by Gordon Hughes (1).pdf 12/19/2023
09s0-0222 GenIC Request Template / SSA Supporting Statement A_NISVS TBI 12.8.23.docx 12/19/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.