Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
2016 CDC Healthcare Systems Scorecard (HSSC) Assessment Tool for Primary Care Practices New 92 26 0 Form none
Form none
Form none
2017 NHANES Health Behaviors Cognitive Interviewing Study New 156 68 0 Form and Instruction 0920-0222 (16AG)
Form and Instruction 0920-0222 (16AG)
Form and Instruction 0920-0222 (16AG)
Form and Instruction 0920-0222 (16AG)
Form and Instruction 0920-0222 (16AG)
2017 NHANES Health Behaviors Cognitive Interviewing Study New 126 38 0 Other-WORD
Other-WORD
2017 NHANES Health Behaviors Cognitive Interviewing Study/Spanish New 68 24 0 Form and Instruction 0920-0222
Form and Instruction 0920-0222
Form and Instruction 0920-0222
Form and Instruction 0920-0222
Instruction
Instruction
CQDER - Opioid Plus Card Sort New 560 230 0 Form and Instruction 0920-0222
Form and Instruction 0920-0222
Center for Questionnaire Design and Evaluation Research (CQDER) CMS 10-day Letter New 100 50 0 Instruction
Form and Instruction 0920-16AEE
Form and Instruction 0920-16AEE
Form and Instruction 0920-16AEE
Cognitive Interviewing Study of Opioid-Related Questions New 360 230 0 Form and Instruction n/a
Form and Instruction n/a
Form n/a
Cognitive Interviewing Study of Opioid-Related Questions (Spanish Version) New 96 68 0 Form and Instruction n/a
Form and Instruction n/a
Form and Instruction n/a
Cognitive Testing of ASPE Criminal Justice System Questions New 117 45 0 Other-WORD
Other-WORD
Cognitive Testing of Impaired Driving Questions for CDC National Center for Injury Prevention and Control (NPIPC) New 112 46 0 Form and Instruction 0920-0222
Form and Instruction 0920-0222
Cognitive Testing of Middle Eastern North African (MENA) Questions New 316 118 0 Form None
Form None
Form None
Cognitive Testing of NHIS health care utilization smoking, and selected child questions New 112 46 0 Form and Instruction 092017AUC
Form and Instruction 0920-17AUC
Cognitive Testing of National Survey of Hospital-Based Victim Services (NSHVS) New 92 26 0 Other-Telephone script
Form none
Form none
Cognitive Testing of Questions on Teen Alcohol and Marijuana Use New 78 34 0 Form and Instruction NA
Form and Instruction NA
Cognitive testing of Confidentiality Pledge, Round 2 New 68 24 0 Other-WORD
Other-WORD
Cognitve Testing of Food for Babies and Mothers' Health Question on the NHANES B24 Month Questionnaire New 185 75 0 Other-WORD
Other-WORD
Other-WoRD
Other-WORD
Collaborating Center for Questionnaire Design and Evaluation Research (CCQDER) New 112 46 0 Form and Instruction 0920-0222
Form and Instruction 0920-0222
Form and Instruction 0920-0222
Form and Instruction 0920-0222
Congitive Testing of Confidentiality Pledges New 68 24 0 Other-Testing Materials
Other-Screening script
Form none
Evaluation of Traumatic Brain Injury Questions for CDC's National Center for Injury Prevention and Control (NCIPC) New 112 46 0 Form and Instruction NA
Form and Instruction NA
GenIC UNICEF/Washington Group School Environment Evaluation Study 2016 New 26 18 0 Other-WORD
Other-WORD
Labor Force Module of Persons with Disabilities New 68 24 0 Other-Telephone Screener
Other-Telephone Questionnaire
Labor Force Module of Persons with Disabilities Round 2 New 68 24 0 Other-WORD
Other-WORD
Other-WORD
Form and Instruction 1
NHANES Contact and Message Testing New 164 105 0 Other-ord
Other-SCREENER
PRAMS - English New 68 34 0 Form none
Form none
PRAMS Phase 8 - Spanish New 68 34 0 Form none
Form and Instruction none
Form none
Questionnaire Design and Evaluation Research on Injury for the National Health Interview Survey (NHIS) New 68 24 0 Form and Instruction NA
Form and Instruction NA
RANDS New 4132 1399 0 Form none
Form none
Form none
Form none
Research and Development Survey (RANDS) Cognitive Interviewing Sub-Study New 200 90 0 Other-WORD
Other-WORD
Spanish Cognitive Study to Examine Traumatic Brain Injury Questions New 58 14 0 Form none
Form and Instruction none
Form none
Testing of questions on cognitive functioning and other questions for the National Health Interview Survey (NHIS) New 112 46 0 Form and Instruction NA
Form and Instruction NA
Trust, Acceptance and Confidence in Vaccines and Vaccination Schedules New 258 124 0 Form and Instruction NA
Form and Instruction NA
Form and Instruction NA
Form and Instruction NA
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 8220 3200 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
To view an IC, click on IC Title