PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Adult Core (sample adult)
Removed
0
0
0
Other-Questionaire
Child / Teen Record Check (medical provider)
Removed
0
0
0
Form
none
Child/Teen
Child Core (adult family member)
Removed
0
0
0
Other-Questionaire
Family Core (adult family member)
Removed
0
0
0
Other-Questionaire
Family Core Questionnaire
New
45000
17250
0
Form and Instruction
None
2015 Family Core Questionnaire
Followback Survey Questionnaire
New
12000
4000
0
Form and Instruction
None
2015 FollowBack Survey Questionnaire
NHCIS Multi-mode Study (adult family member)
Removed
0
0
0
Form
none
NHCIS
Native Hawaiian / Pacific Islander Survey (adult family member)
Removed
0
0
0
Form
none
Native Hawaiian Pacific Islander
New Supplements and Core Changes
New
45000
15000
0
Form and Instruction
None
2015 New Supplements and Core Changes
OMB Statement and Screener
New
10000
833
0
Form and Instruction
None
2015 OMB Statement and Screener
Reinterview Survey
Removed
0
0
0
Form
none
Reinterview
Reinterview Survey
New
5000
417
0
Form and Instruction
None
2015 Reinterview Survey
Sample Adult Core Questionnaire
New
36000
9000
0
Form and Instruction
None
2015 Sample Adult Core Questionnaire
Sample Child Core Questionnaire
New
14000
2333
0
Form and Instruction
None
2015 Sample Child Core Questionnaire
Screener Questionnaire
Removed
0
0
0
Form
none
Screener
Supplements (adult family member)
Removed
0
0
0
Form
none
Supplements
Total burden requested under this ICR:
167000
48833
0
To view an IC, click on IC Title