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