Information Collection

NHIS Teen Cognitive Testing

IC 263925 under ICR 202508-0607-002 · OMB 0607-0725.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 NHIS Teen Cognitive Testing	Form and Instruction
Form 1 Questionnaire NHIS Teen Cognitive Testing	Form and Instruction
1 Questionnaire NHIS Teen 2023 Questionnaire (Attachment III).docx	Form and Instruction
1 Questionnaire NHIS Teen 2023 Questionnaire (Attachment III).docx	Form and Instruction
NHIS TEEN OMB letter (Attachment IV).docx OMB Memo	IC Document
NHIS TEEN OMB letter (Attachment IV).docx OMB Memo	IC Document
NHIS TEEN Communications (Attachment I).docx Communications Material	IC Document
NHIS TEEN Communications (Attachment I).docx Communications Material	IC Document
NHIS TEEN Cog Test Protocol (Attachment II).docx Protocol	IC Document
NHIS TEEN Cog Test Protocol (Attachment II).docx Protocol	IC Document

IC Title:

NHIS Teen Cognitive Testing

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1				No		Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 35

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	35	35
Annual IC Time Burden (Hours)	57	57
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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

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