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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Cognitive Testing of the 2023 National Survey of Children's Health Longitudinal Cohort Questionnaire
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
1
Version LC1
2023 NSCH-LC1 Cognitive Interviewing_OMB_v2.pdf
No
Fillable Fileable
Form and Instruction
2
Version LC2 and LC3
2023 NSCH-LC2_LC3 Cognitive Interviewing_OMB_v2.pdf
No
Fillable Fileable
Form and Instruction
3
Version LC4
2023 NSCH-LC4 Cognitive Interviewing_OMB_v2.pdf
No
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Central Records & Statistical Mgt
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
40
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
40
0
40
0
0
0
Annual IC Time Burden (Hours)
47
0
47
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
OMB Memo
2023 NSCH-LC Cognitive Interviewing OMB Letter.docx
02/14/2022
Consent Form
2023 NSCH-LC Cognitive Interviewing Consent Form_OMB_v2.docx
02/14/2022
Protocol Version 1, 2, 3
2023 NSCH-LC 1_2_3 Cognitive Testing Protocol_OMB.docx
02/14/2022
Protocol Version 4
2023 NSCH-LC 4 Cognitive Testing Protocol_OMB.docx
02/14/2022
Screener
2023 NSCH-LC Cognitive Interviewing Participant Screener_OMB.docx
02/14/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.