Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
2013 NHIS Health Insurance Web and Cognitive Interview Study
New
1550
300
0
Form and Instruction
none
Screener
Instruction
Form and Instruction
4
Questionnaire
2015 NHIS Occupational Health Supplement and Cancer Control Supplement
New
70
70
0
Other-WORD
Other-WORD
Form
none
Cancer Control - Questionniare
Form
none
Cancer Control - screener
2015 National Electronic Health Records Survey
New
134
57
0
Form
none
National Electronic Health Records Survey 2015
Form and Instruction
none
Screener
Form
none
Respondent Data Sheet
4 Sets of Health Questions and Blood Donor History Questionnaire Evaluation
New
125
125
0
Form and Instruction
none
Four Sets of Health Related Questions
Form and Instruction
none
Blood Donor History Questionnaire
Adult and Child Disability Questions
New
100
100
0
Form and Instruction
none
Screening Script
Form
none
Adult Disability Questions
Form
none
Child Disability Questions
Cognitive Testing of Adults with Chronic Health Care Needs
New
60
60
0
Form and Instruction
none
Adults with Chronic Health Care Needs
Cognitive testing of High-impact, Chronic Pain questions - NCHS Questionnaire Design Research Laboratory (QDRL)
New
112
46
0
Form and Instruction
None
Telephone Screener
Form and Instruction
None
Pain Questionnaire to be evaluated
Diabetes Primary Prevention
New
117
51
0
Form
none
Questionnaire
Form
none
Screener
Evaluate Cervical and Lung Cancer Screening Questions
New
112
46
0
Form
none
Screener
Form
none
Questionnaire
Evaluation of Uniform Donor History Questionnaire and Evaluation of Violence Against Children Survey (VACS)- Malawi
New
65
75
0
Form and Instruction
None
Attachment 1 Uniform Donor History Questionnaire
Form
None
What to do when a loved one dies-A survivor's checklist
Form
None
Attachment 1: Violence Against Children Survey - Malawi: Age 13-24 years
GENERIC IC Gen IC Questionnaire Design Research Lab - 2013 Comparative Disability Questions and Mode Effects Study
New
120
180
0
Form
None
Attachment 1a: WHO Questionnaire
Form
None
Attachment 1b: Washington Group Questionnaire
Form and Instruction
None
Attachments 3a & 3b--Telephone Screeners
NAMCS Feasibility Study
New
2268
779
0
Form and Instruction
none
Physician Survey
Form and Instruction
none
Medical Organization Survey
Form and Instruction
none
Phys and Organization Survey
NHIS College Housing Frame Questionnaire Study
New
300
50
0
Other-WORD
Pregnancy Risk Assessment Monitoring System
New
50
75
0
Form
none
PRAMS Phase 8
Form and Instruction
none
Screener
Form
none
Consent
Form
none
Respondent Data
Questionnaire Design Research Lab (2016 NAMCS Culturally and Linguistically Appropriate Services (CLAS) Supplement Evaluation)
New
68
24
0
Form and Instruction
0920-0222
Attach 1 Q8 050615 (2)
Form and Instruction
0920-0222
Attach 3 - CLAS Phone screener
Questionnaire Design Research Lab: 5600 Case CAPI and ACASI NHIS Field Test
New
5600
5600
0
Form and Instruction
none
Proposed ACASI Questions
Form and Instruction
none
HIS-100C, January 2011 Manual for NHIS Field Reps Explaning the Survey
Teen Disability and Demographic Questions Cognitive Interviewing Study
New
200
100
0
Form and Instruction
none
Questionnaire
Form and Instruction
none
Screener
Testing Long-term Care Questions
New
26
26
0
Form
none
NSLTP - Adult Day Services Center
Form
none
NSLTP - Residential Care Community
Form and Instruction
none
Screeners
UNICEF/Washington Group School Environment Study
New
73
29
0
Form
none
Questionnaire
Form
none
Screener
Violence Against Children Survey Evaluation Study - Philippines
New
40
80
0
Form
none
Violence Against Children Survey
Total Burden Actually Used for Information Collections Under Currently Approved ICR:
11190
7873
0
Total Burden Currently Requested for Information Collections Under Currently Approved ICR:
0
0
0
To view an IC, click on IC Title