Information Collection

[NCHS] BMI Focus Groups

IC 271058 under ICR 202504-0920-019 · OMB 0920-0222.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0222 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-24IT [NCHS] BMI Focus Groups Form
Form 0920-24IT Respondent Data Collection [NCHS] BMI Focus Groups Form
Form 0920-24IT Respondent Informed Consent [NCHS] BMI Focus Groups Form
0920-24IT Respondent Data Collection Attachment 3 - Respondent Data Collection Sheet.docx Form
0920-24IT Respondent Data Collection Attachment 3 - Respondent Data Collection Sheet.docx Form
0920-24IT Respondent Informed Consent Attachment 2 - Informed Consent CLEAN 9.5.24.docx Form
0920-24IT Respondent Informed Consent Attachment 2 - Informed Consent CLEAN 9.5.24.docx Form
Attachment 4 - CCQDER Data Retention Policy.docx CCQDER Data Retention Policy IC Document
Attachment 4 - CCQDER Data Retention Policy.docx CCQDER Data Retention Policy IC Document
Supporting Statement A Growth Chart Focus Groups- 8.28.24.docx SSA IC Document
Supporting Statement A Growth Chart Focus Groups- 8.28.24.docx SSA IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	[NCHS] BMI Focus Groups	Agency IC Tracking Number:	0920-0222-24IT

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	0920-24IT	Respondent Data Collection	Attachment 3 - Respondent Data Collection Sheet.docx		Yes	Yes	Fillable Fileable
Form	0920-24IT	Respondent Informed Consent	Attachment 2 - Informed Consent CLEAN 9.5.24.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
CCQDER Data Retention Policy	Attachment 4 - CCQDER Data Retention Policy.docx	09/19/2024
SSA	Supporting Statement A Growth Chart Focus Groups- 8.28.24.docx	09/19/2024

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].