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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
[NCHS] Rands 13 Personality Traits, Access to Primary Care, and Other Questions,
Agency IC Tracking Number:
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
0920-26-0253
Screener
OMB0920-0222_Attachment 4 - Screening Script.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-26-0253
RANDS 13 Web and Phone Questionnaire
OMB0920-0222_Attachment 1a- RANDS 13 Web and Phone Questionnaire.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-26-0253
Data Collection Sheet
OMB0920-0222_Attachment 6 - Data Collection Sheet.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-26-0253
Questions to be Cognitive Tested
OMB0920-0222_Attachment 1b- Questions to be Cognitive Tested.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
12,075
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
12,075
0
12,075
0
0
0
Annual IC Time Burden (Hours)
4,024
0
4,024
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
30 Day FRN
OMB0920-0222_30 Day FRN_4.20.2026.docx
09/09/2026
60 Day FRN Comment
OMB0920-0222_60 Day FRN Comment_4.20.26.pdf
09/09/2026
SSA
OMB0920-0222_Supporting Statement A_0106.docx
09/09/2026
SSB
OMB0920-0222_Supporting Statement B_0106.docx
09/09/2026
OMB0920-0222_Attachment 2 - Previous Use and Development
OMB0920-0222_Attachment 2 - Previous Use and Development.docx
09/09/2026
Attachment 3- Advertisement
OMB0920-0222_Attachment 3- Advertisement.docx
09/09/2026
Attachment 5 - Informed Consent
OMB0920-0222_Attachment 5 - Informed Consent.docx
09/09/2026
Attachment 7 - Thank You Letter
OMB0920-0222_Attachment 7 - Thank You Letter.docx
09/09/2026
Attachment 8 -Data Storage and Access Policy
OMB0920-0222_Attachment 8 -Data Storage and Access Policy.docx
09/09/2026
Attachment 9 - NCHS Non-Disclosure Affidavit
OMB0920-0222_Attachment 9 - NCHS Non-Disclosure Affidavit.docx
09/09/2026
Response to 60d FRN Public Comment_4.20.26
OMB0920-0222_CCQDER Response to 60d FRN Public Comment_4.20.26.docx
09/09/2026
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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