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[NCHS] Evaluation of Revised Questions on Cannabis Use and Experiences

IC 264921 under ICR 202504-0920-019 · OMB 0920-0222.

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[NCHS] Evaluation of Revised Questions on Cannabis Use and Experiences 0920-0222-24CS
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Cannabis Questions to be Cognitively Tested Attachment 1- Cannabis Questions.docx Yes Yes Fillable Fileable
Form and Instruction n/a Cannabis Screening Script Attachment 4 - Cannabis Screening Script- Clean 1.9.24.docx Yes No Fillable Fileable
Form and Instruction n/a Cannabis Data Collection Sheet Attachment 6- Cannabis Data Collection Sheet.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

200 0
   
Individuals or Households
 
   95 %

  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 200 0 0 0 0 200
Annual IC Time Burden (Hours) 58 0 0 0 0 58
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA SSA-Cannabis-2024-Streamline-1.30.24_final.docx 02/05/2024
Question Provenance Attachment 2 - Question Provenance.docx 02/05/2024
Cannabis Advertisment Attachment 3- Cannabis Advertisement.docx 02/05/2024
Informed Consent Attachment 5 - Cannabis Informed Consent- CLEAN 1.5.24.docx 02/05/2024
Thank You Letter Attachment 7- Thank You Letter.docx 02/05/2024
NCHS Non-Disclosure Affidavit Attachment 8- NCHS Non-Disclosure Affidavit.docx 02/05/2024
Data Retention Policy Attachment 9-Data Retention Policy.docx 02/05/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.