OMB control number

Health Information National Trends Survey V (HINTS V) (NCI)

OMB 0925-0538 · HHS/NIH.

OMB 0925-0538

Latest Forms, Documents, and Supporting Material

Document Name
Form 2 Pilot Study Form
Form 1 Individual Main Study Form
Form 1 Health Information National Trends Survey Form and Instruction
30-Day FRN HINTS.pdf Supplementary Document
Appendix G2 - Privacy Act Memo.pdf Supplementary Document
Appendix M - References.pdf Supplementary Document
Appendix L - Instrument Changes.pdf Supplementary Document
Appendix K- Theoretical Framework.pdf Supplementary Document
Appendix J2 - Westat IRB Approval.pdf Supplementary Document
Appendix J1 - NCI OHSRP Determination.pdf Supplementary Document
Appendix I - Westat Confidentiality Pledge.pdf Supplementary Document
Appendix H - OMB approved incentives.pdf Supplementary Document
Appendix G1 - PIA.pdf Supplementary Document
Appendix F - Health People 2020 Objectives.pdf Supplementary Document
Appendix C - HINTS IV Publications Overview .pdf Supplementary Document
Appendix B - Cover Letters & FAQs.pdf Supplementary Document
Appendix A - History of HINTS.pdf Supplementary Document
SSA HINTS Final 8.17.2016.docx Supporting Statement A
SSB HINTS Final.docx Supporting Statement B
Pilot Study Form
Individual Main Study Form
Health Information National Trends Survey Form and Instruction

All Historical Document Collections

201608-0925-002 Withdrawn	Reinstatement with change of a previously approved collection	2016-08-25
201502-0925-003 Approved without change	Reinstatement with change of a previously approved collection	2015-02-23
201407-0925-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2014-07-03
201306-0925-007 Approved without change	No material or nonsubstantive change to a currently approved collection	2013-06-20
201303-0925-007 Improperly submitted and continue	No material or nonsubstantive change to a currently approved collection	2013-03-29
201206-0925-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2012-06-05
201107-0925-002 Approved with change	Reinstatement with change of a previously approved collection	2011-07-14
200802-0925-004 Approved without change	Extension without change of a currently approved collection	2008-02-20
200801-0925-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2008-01-07
200712-0925-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2007-12-06
200711-0925-004 Improperly submitted and continue	No material or nonsubstantive change to a currently approved collection	2007-11-20
200708-0925-001 Improperly submitted and continue	No material or nonsubstantive change to a currently approved collection	2007-08-08
200707-0925-001 Approved with change	Revision of a currently approved collection	2007-07-26
200407-0925-002 Approved with change	New collection (Request for a new OMB Control Number)	2004-07-23