Information Collection

National Survey on Drug Use and Health: Questionnaire Change Flexibilities Online Panel/Platform Test

IC 251019 under ICR 201912-0930-002 · OMB 0930-0290.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0290 can be found here:

Documents and Forms

Document Name Document Type
Form NSDUH Questionnair National Survey on Drug Use and Health: Questionnaire Change Flexibilities Online Panel/Platform Test Form and Instruction
NSDUH Questionnair NSDUH Questionnaire Change Flexibilities Survey Attachment E_Survey_Questions.docx Form and Instruction
NSDUH Questionnair NSDUH Questionnaire Change Flexibilities Screener Attachment A_Screening_Criteria.docx Form and Instruction
NSDUH Questionnaire Change Flexibilities Online Panel-Platform Test Supporting Statement B.docx NSDUH Questionnaire Change Flexibilities Online Panel-Platform Test Supporting Statement B IC Document
Attachment B_MTurk Parental Permission_Youth Assent.docx Attachment B_MTurk Parental Permission_Youth Assent IC Document
Attachment C_Participant_Informed_Consent_Screens_Adult.docx Attachment C_Participant_Informed_Consent_Screens_Adult IC Document
Attachment D_Participant_Informed_Consent_Screens_Adolescent.docx Attachment D_Participant_Informed_Consent_Screens_Adolescent IC Document
Attachment F_Federalwide Assurance.pdf Attachment F_Federalwide Assurance IC Document
NSDUH Questionnaire Change Flexibilities Online Panel-Platform Test Supporting Statement A.docx NSDUH Questionnaire Change Flexibilities Online Panel-Platform Test Supporting Statement A IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	National Survey on Drug Use and Health: Questionnaire Change Flexibilities Online Panel/Platform Test	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	NSDUH Questionnaire Change Flexibilities Survey	NSDUH Questionnaire Change Flexibilities Survey	Attachment E_Survey_Questions.docx		Yes	Yes	Fillable Fileable
Form and Instruction	NSDUH Questionnaire Change Flexibilities Screener	NSDUH Questionnaire Change Flexibilities Screener	Attachment A_Screening_Criteria.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: National Survey on Drug Use and Health: Questionnaire Change Flexibilities Online Panel/Platform Test	FR Citation: 75 FR 28264

Number of Respondents: 20,420	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20,420	20,420
Annual IC Time Burden (Hours)	1,870	1,870
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
NSDUH Questionnaire Change Flexibilities Online Panel-Platform Test Supporting Statement B	NSDUH Questionnaire Change Flexibilities Online Panel-Platform Test Supporting Statement B.docx	01/11/2022
Attachment B_MTurk Parental Permission_Youth Assent	Attachment B_MTurk Parental Permission_Youth Assent.docx	01/11/2022
Attachment C_Participant_Informed_Consent_Screens_Adult	Attachment C_Participant_Informed_Consent_Screens_Adult.docx	01/11/2022
Attachment D_Participant_Informed_Consent_Screens_Adolescent	Attachment D_Participant_Informed_Consent_Screens_Adolescent.docx	01/11/2022
Attachment F_Federalwide Assurance	Attachment F_Federalwide Assurance.pdf	01/11/2022
NSDUH Questionnaire Change Flexibilities Online Panel-Platform Test Supporting Statement A	NSDUH Questionnaire Change Flexibilities Online Panel-Platform Test Supporting Statement A.docx	01/11/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.