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National Intimate Partner and Sexual Violence Survey (NISVS) - Developmental Testing
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0822 Developmental Testing Tool for NISVS Developmental Testing for NISVS - Mock Instrument 08FEB2018.docx NA Yes Yes Fillable Fileable
Form and Instruction 0920-0822 NISVS - CATI COGNITIVE TESTING INSTRUMENT, ROUND 1 Att C. NISVS CATI Cognitive Testing Instrument.docx NA No   Fillable Fileable
Form and Instruction 0920-0822 NISVS - PAPER COGNITIVE TESTING INSTRUMENT, ROUND 1 Att D. NISVS Paper Cognitive Testing Instrument.docx NA No   Paper Only
Form and Instruction 0920-0822 NISVS - WEB-BASED COGNITIVE TESTING INSTRUMENT, ROUND 1 Att E. NISVS Web-Based Cognitive Testing Instrument.docx NA Yes Yes Fillable Fileable

Health Public Health Monitoring

Epidemiologic Studies and Surveillance of Disease Problems  57 FR 62812

5,700 0
   
Individuals or Households
 
   50 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 5,700 0 0 0 0 5,700
Annual IC Time Burden (Hours) 2,636 0 120 0 0 2,516
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Description of Program Changes/Adjustments Att A. Description of Program Changes and Adjustments OMB_CDC revision_CLEAN 6.10.19.docx 06/14/2019
Cognitive Testing Plan Att F. Cognitive Testing Plan.docx 06/14/2019
Cognitive Testing Recruitment Ad Att G. Cog Testing Recruitment Ad.docx 06/14/2019
Web-based Recruitment Screener Att H. Recruiting Screener.docx 06/14/2019
Cognitive Testing Informed Consent Att I. Cog Testing Informed Consent.docx 06/14/2019
CATI Instrument Cognitive Testing Protocol Att J. CATI Instrument Cog Testing Protocol.docx 06/14/2019
PAPER Instrument Cognitive Testing Protocol Att K. Paper Instrument Cog Testing Protocol.docx 06/14/2019
WEB-BASED Instrument Cognitive Testing Protocol Att L. Web-based Instrument Cog Testing Protocol.docx 06/14/2019
Crosswalk of NISVS Instrument Revisions Att. B Crosswalk of NISVS Instrument Revisions for OMB_CDC revision_CLEAN_6.6.19.docx 06/14/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.