Child and Adolescent Psychiatric Assessment : Child Version

Calibration of the Short Strengths and Difficulties Questionnaire (SDQ) in the National Health Interview Survey (NHIS)

Documents and Forms

Document Name Document Type
Form 13 Child and Adolescent Psychiatric Assessment : Child Version Form and Instruction
13 Child and Adolescent Psychiatric Assessment : Child Vers Att E 1 CAPA (Child) E1-E50.pdf Form and Instruction
14 Child and Adolescent Psychiatric Assessment : Child Vers Att E 2 CAPA (Child) pp E51 - E100.pdf Form and Instruction
15 Child and Adolescent Psychiatric Assessment : Child Vers Att E 3 CAPA (Child) pp E101 - E150.pdf Form and Instruction
16 Child and Adolescent Psychiatric Assessment : Child Vers Att E 4 CAPA (Child) E151 - E203.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Child and Adolescent Psychiatric Assessment : Child Version	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	13	Child and Adolescent Psychiatric Assessment : Child Version	Att E 1 CAPA (Child) E1-E50.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	14	Child and Adolescent Psychiatric Assessment : Child Version	Att E 2 CAPA (Child) pp E51 - E100.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	15	Child and Adolescent Psychiatric Assessment : Child Version	Att E 3 CAPA (Child) pp E101 - E150.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	16	Child and Adolescent Psychiatric Assessment : Child Version	Att E 4 CAPA (Child) E151 - E203.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0164 Health and Demographic Surveys Conducted in Probability Samples of the U. S. Population	FR Citation: 49 FR 37693

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	225	225
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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