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
Cannabis Questions
New
540
122
0
Form and Instruction
0920-21GG
Screener
Form and Instruction
0920-21GG
Question Provenance
Form and Instruction
0920-21GG
Questionnaire
Form and Instruction
0920-21GG
Data Collection Sheet
Form and Instruction
0920-21GG
Follow Up Interview
Cognitive Interview Study: Spanish-language Telephone-administered Questions for PRAMS (2019)
New
80
35
0
Form and Instruction
n/a
Telephone Screening Script (in Spansih)
Form and Instruction
n/a
PRAMS 2019 questions to be cognitively tested (Phone/Spanish version)
Form and Instruction
n/a
Respondent Data Sheet (in Spanish)
Cognitive Test for ACS Disability Questions and NHIS Child Behavior Questions
New
80
47
0
Form and Instruction
n/a
Telephone Screener
Form and Instruction
n/a
ACS Booklet and Selected NHIS Questions Discussed During the Cognitive Interview
Form and Instruction
n/a
Respondent Data Collection Sheet (Demographics)
Cognitive Test for NHIS Questions and Opiods
New
160
49
0
Form and Instruction
0920-0222
Questions to be Cognitively Tested
Form and Instruction
0920-0222
Screeners
Form and Instruction
0920-0222
Respondent Data Collection Sheet
Cognitive Test for the Pregnancy Risk Assessment Monitoring System (PRAMS)
New
80
35
0
Form and Instruction
0920-0222
2019 Questions for Cognitive Testing
Form and Instruction
0920-0222
Screener
Form and Instruction
0920-0222
Respondent Data
Cognitive Testing for American Community Survey
New
400
119
0
Form and Instruction
none
Telephone screeners
Form
none
Interview instrument
Form
none
Respondent data collection sheets
Cognitive Testing of 2021 Occupational Health Supplement Questions
New
75
23
0
Form
0920-0222
Questions for Consideration NHIS-OHS 2021 Supplement
Instruction
Form
0920-0222
Respondent Data Collection Sheet
Cognitive Testing of Adverse Childhood Events Questions for the Youth Risk Behavior Surveillance System (YRBSS)
New
290
71
0
Form and Instruction
0920-0222
Respondent Screener
Form and Instruction
0920-0222
Screener Parent/Guardian
Other-Virtual interview Zoom/Skype set up support
Form and Instruction
0920-0222
Questionnaire - uestions to be Cognitively tested
Form and Instruction
0920-0222
Respondent Data Collection Sheets - In-person/Virtual
Form and Instruction
0920-0222
Respondent Debriefing Interview
Cognitive Testing of Occupational Safety and Health Questions for the Youth Risk Behavior Surveillance System (YRBSS) [with incentive level test]
New
150
71
0
Form and Instruction
n/a
Telephone Screening Script (for Target Respondents)
Form and Instruction
n/a
Telephone Screening Script (for Parent / Guardian)
Other-Virtual Interview Setup Support [see Sections III and IV]
Form and Instruction
n/a
Questions to be Cognitively Tested
Form and Instruction
n/a
Respondent Data Collection Sheet
Form and Instruction
n/a
Follow-up Debriefing Discussion
Cognitive Testing of Physician Opioid Questions
New
90
26
0
Form
none
National Survey on Best Practices for Patient Pain Management and Opioid Use
Other-Telephone script
Form
none
Respondent data collection sheet
Cognitive Testing of Questions on Complementary Health Approaches and Well-being
New
140
55
0
Form and Instruction
n/a
Telephone Screener
Form and Instruction
n/a
NHIS Complementary Health Approaches and Well-being Questionnaire
Form and Instruction
n/a
Respondent Data Collection Sheet [demographics]
NCHS Research and Development Survey (RANDS)
New
4000
1333
0
Form and Instruction
0920-0222
Web Questionnaire Introduction Screen and RANDS Questionnaire
NIOSH Virtual Cognitive Interview Study
New
90
31
0
Form and Instruction
none
Telephone screener
Form and Instruction
none
NIOSH questionnaire
Form and Instruction
none
Respondent data sheet
NSCH "Healthy and Ready to Learn" Questions 2020 (Self-administered/English)
New
305
93
0
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
NSFG Life History Calendar Evaluation
New
120
36
0
Form and Instruction
0920-0222
Attachment 1a: Questions to be cognitively tested
Form and Instruction
0920-0222
Attachment 1b - Life History Calendar Worksheet (Recall Aide)
Form and Instruction
0920-0222
Attachment 3a – Telephone Screening Script – Respondent recruited from newspaper advertisement/flyer
Form and Instruction
0920-0222
Attachment 3b – Telephone Screening Script – Respondent recruited from CCQDER Respondent Database
Form and Instruction
0920-0222
Attachment 5: Respondent Data Collection Sheet
NSFG Testing
New
300
95
0
Form and Instruction
0920-21EC
Telephone Screener
Form and Instruction
0920-21EC
Virtual Interviews Data collection Sheet
Form
0920-21EC
Respondent Debriefing
Form
1
Test Questions
National Health and Nutrition Examination Survey (NHANES – Growth Chart)
New
40
60
0
Form and Instruction
n/a
Focus Group Protocol (NHANES Growth Chart)
Form and Instruction
n/a
Data Collection Sheet (participant demographics)
PRAMS Opioid 2018 - English
New
176
68
0
Form
none
PRAMS Opioid 2018
Form
none
Telephone Screener
Form
none
Respondent Data Sheet
PRAMS Opioid 2018 -Spanish
New
98
34
0
Form
none
PRAMS Opioid 2018 - Spanish
Form
none
Telephone Screener - Spanish
Form
none
Respondent Data Collection Sheet
RANDS - NISVS
New
6780
2242
0
Form and Instruction
0920-0222
Questionnaire 55 minute
Form and Instruction
0920-0222
Questionnaire 20 minute
Form and Instruction
0920-0222
Telephone screener - flyer and database
Form and Instruction
0920-0222
Respondent Data Collection Sheet
Form and Instruction
0920-0222
Respondent Debriefing
RANDS NSFG
New
2200
734
0
Form and Instruction
0920-0222
RANDS NSFG Web Questionnaire
The Research and Development Survey (RANDS 4 -- Telephone Sample)
New
1200
400
0
Other-WORD
Other-WORD
Other-WORD
Validity Study of Intellectual and Disability Questions
New
320
94
0
Other-WORD
Other-WORD
Other-WORD
Total Burden Actually Used for Information Collections Under Currently Approved ICR:
17714
5873
0
Total Burden Currently Requested for Information Collections Under Currently Approved ICR:
0
0
0
To view an IC, click on IC Title