OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

[NCIPC] The National Intimate Partner and Sexual Violence Survey (NISVS)

OMB 0920-0822 ยท HHS/CDC.

OMB 0920-0822

The National Intimate Partner and Sexual Violence Survey is an ongoing, nationally representative survey of non-institutionalized adult men and women aged 18 years or older in the United States assessing lifetime experiences to assess experiences of intimate partner violence, sexual violence and stalking among adults in the US. . It measures lifetime victimization for these types of violence as well as in the previous 12 months. NISVS has historically been administered through random-digit-dial sampling. From 2018-2021, CDC conducted feasibility testing and pilot testing aimed at developing methods for transitioning NISVS to an address-based sampling design that would reduce reliance on cell and landline phone participation and improve response rates. The modification in this revision request is to do a full-scale implementation of address-based sampling frame with push-to-web data collection and a call-in telephone option, intended to increase the response rate, and reduce respondent burden.

The latest form for [NCIPC] The National Intimate Partner and Sexual Violence Survey (NISVS) expires 2026-05-31 and is listed under ICR 202503-0920-002.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 0920-0822 Att L_Web_Phone Screeners and Survey Instrument_SpanishForm and Instruction
Form 0920-0822 Att K_Web_Phone Screeners and Survey Instrument_EnglishForm and Instruction
Form 0920-0822 Questionnaire, phone (Att. K-L)Form and Instruction
Form 0920-0822 Att L_Web_Phone Screeners and Survey Instrument_SpanishForm and Instruction
Form 0920-0822 Att K_Web_Phone Screeners and Survey Instrument_English_REV1.10.23CleanForm and Instruction
Form 0920-0822 Questionnaire, web (Att. K-L)Form and Instruction
Form 0920-0822 Att N_Paper Screener_SpanishForm and Instruction
Form 0920-0822 Att K_Web_Phone Screeners and Survey Instrument_EnglishForm and Instruction
Form 0920-0822 Screener (Att. K-N )Form and Instruction
Form 0920-0822 Att T_Advance Letters_SpanishForm and Instruction
Form 0920-0822 Att S_Advance Letters_EnglishForm and Instruction
Form 0920-0822 Advance Letter (Att. S-T)Form and Instruction
CHANGE REQUEST 0920-0822_Common Form.docxJustification for No Material/Nonsubstantive Change
CHANGE REQUEST 0920-0822_Common Form.docx Justification for No Material/Nonsubstantive Change
SSA_0822_NISVS_10.16.23_CLEAN.docxSupplementary Document
SSA_0822_NISVS_10.16.23_CLEAN.docx Supplementary Document
NISVS_Non-substantive Change Request_10.19.2023.docxSupplementary Document
NISVS_Non-substantive Change Request_10.19.2023.docx Supplementary Document
Att I_Overview of NISVS-5 Survey Revisions_REV1.10.23Clean.docxSupplementary Document
Att I_Overview of NISVS-5 Survey Revisions_REV1.10.23Clean.docx Supplementary Document
Att H_NISVS Cognitive Testing Reports.pdfSupplementary Document
Att H_NISVS Cognitive Testing Reports.pdf Supplementary Document
Att G_NISVS Redesign_Pilot Test Final Report.docxSupplementary Document
Att G_NISVS Redesign_Pilot Test Final Report.docx Supplementary Document
Att F_Nonresponse Follow-up Study Report.docxSupplementary Document
Att F_Nonresponse Follow-up Study Report.docx Supplementary Document
Att E_Feasibility Study Report.docxSupplementary Document
Att E_Feasibility Study Report.docx Supplementary Document
Att B_Federal register notice.pdfSupplementary Document
Att B_Federal register notice.pdf Supplementary Document
Att A_AuthLeg_0822.docxSupplementary Document
Att A_AuthLeg_0822.docx Supplementary Document
Att R_PIA_NISVS.pdfSupplementary Document
Att R_PIA_NISVS.pdf Supplementary Document
Att U_Research or Non-Research Determination for NISVS.pdfSupplementary Document
Att U_Research or Non-Research Determination for NISVS.pdf Supplementary Document
NISVS Change Request 04JUN2021.docxJustification for No Material/Nonsubstantive Change
IRB Approval.pdfSupplementary Document
IRB Approval.pdf Supplementary Document
OMB Change Request for NISVS_5.4.21_FINAL (003).docxJustification for No Material/Nonsubstantive Change
OMB Change Request for NISVS_5.4.21_FINAL (003).docx Justification for No Material/Nonsubstantive Change
Att O_Pilot Sample Design and Data Collection Procedures.docxSupplementary Document
Att O_Pilot Sample Design and Data Collection Procedures.docx Supplementary Document
Att N_Westat Recommendations for NISVS.docxSupplementary Document
Att N_Westat Recommendations for NISVS.docx Supplementary Document
Att K_Crosswalk of Survey Revisions.docxSupplementary Document
Att K_Crosswalk of Survey Revisions.docx Supplementary Document
Att J_Screener Thank You Letter_CLEAN.docxSupplementary Document
Att I.5_Reminder Postcard_CLEAN.docxSupplementary Document
Att I.5_Reminder Postcard_CLEAN.docx Supplementary Document
Att I.4_Survey Follow-up Letter_CLEAN.docxSupplementary Document
Att I.4_Survey Follow-up Letter_CLEAN.docx Supplementary Document
Att I.3_Screener Follow-up Letter_CLEAN.docxSupplementary Document
Att I.3_Screener Follow-up Letter_CLEAN.docx Supplementary Document
Att I.2_Advance Letter for Survey_CLEAN.docxSupplementary Document
Att I.2_Advance Letter for Survey_CLEAN.docx Supplementary Document
Att I.1_Advance Letter for Screener_CLEAN.docxSupplementary Document
Att I.1_Advance Letter for Screener_CLEAN.docx Supplementary Document
AttL_Cognitive Testing Protocol.docxSupplementary Document
AttL_Cognitive Testing Protocol.docx Supplementary Document
AttK.2_NISVS Workgroup Summary.docxSupplementary Document
AttK.2_NISVS Workgroup Summary.docx Supplementary Document
AttK.1_NISVS Workgroup Participants.docxSupplementary Document
AttK.1_NISVS Workgroup Participants.docx Supplementary Document
AttG_PIA_NISVS.pdfSupplementary Document
AttG_PIA_NISVS.pdf Supplementary Document
AttF_Security Agreement.pdfSupplementary Document
AttF_Security Agreement.pdf Supplementary Document
AttD_IRB Approval.pdfSupplementary Document
AttD_IRB Approval.pdf Supplementary Document
AttC_Outside Consultation.pdfSupplementary Document
AttC_Outside Consultation.pdf Supplementary Document
AttB1_60Day - FRN-0822.pdfSupplementary Document
AttB1_60Day - FRN-0822.pdf Supplementary Document
AttA_AuthLeg_0822.docxSupplementary Document
AttA_AuthLeg_0822.docx Supplementary Document
SSB_NISVS_12.7.22.docxSupporting Statement B
SSB_NISVS_12.7.22.docxSupporting Statement B
SSA_0822_NISVS_12.7.22_revised 3.28.23_CLEAN.docxSupporting Statement A
SSA_0822_NISVS_12.7.22_revised 3.28.23_CLEAN.docxSupporting Statement A
Questionnaire, phone (Att. K-L) Form and Instruction
Questionnaire, phone (Att. K-L) Form and Instruction
Questionnaire, phone (Att. K-L) Form and Instruction
Questionnaire, web (Att. K-L) Form and Instruction
Questionnaire, web (Att. K-L) Form and Instruction
Questionnaire, web (Att. K-L) Form and Instruction
Screener (Att. K-N ) Form and Instruction
Screener (Att. K-N ) Form and Instruction
Screener (Att. K-N ) Form and Instruction
Advance Letter (Att. S-T) Form and Instruction
Advance Letter (Att. S-T) Form and Instruction
Advance Letter (Att. S-T) Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202503-0920-002 No material or nonsubstantive change to a currently approved collection 2025-03-28
202311-0920-009 No material or nonsubstantive change to a currently approved collection 2023-11-09 Approved without change
202302-0920-017 Revision of a currently approved collection 2023-02-16 Approved with change
202105-0920-008 No material or nonsubstantive change to a currently approved collection 2021-05-26 Approved without change
202001-0920-001 Revision of a currently approved collection 2020-01-29 Approved with change
201906-0920-002 No material or nonsubstantive change to a currently approved collection 2019-06-17 Approved without change
201903-0920-007 No material or nonsubstantive change to a currently approved collection 2019-04-08 Improperly submitted and continue
201712-0920-001 Revision of a currently approved collection 2017-12-27 Approved with change
201604-0920-012 Revision of a currently approved collection 2016-05-13 Approved with change
201601-0920-018 No material or nonsubstantive change to a currently approved collection 2016-02-02 Approved without change
201410-0920-019 Reinstatement with change of a previously approved collection 2014-11-10 Approved with change
201305-0920-005 Revision of a currently approved collection 2013-05-10 Approved without change
201209-0920-002 Revision of a currently approved collection 2012-09-04 Approved without change
201011-0920-004 No material or nonsubstantive change to a currently approved collection 2010-11-09 Approved without change
201004-0920-003 No material or nonsubstantive change to a currently approved collection 2010-04-12 Approved without change
201003-0920-003 No material or nonsubstantive change to a currently approved collection 2010-03-10 Approved without change
200906-0920-020 New collection (Request for a new OMB Control Number) 2009-06-29 Approved without change

OMB Details

Advance Letter (Att. S-T)

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
FormNameElectronic accessType
Form 0920-0822Att T_Advance Letters_SpanishFillable FileableForm and instruction
Form 0920-0822Att S_Advance Letters_EnglishFillable FileableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.