In-Person Interview

National Mental Health Study (NMHS) Field Test

Documents and Forms

Document Name Document Type
Form In-Person Intervie In-Person Interview Form and Instruction
In-Person Intervie In-Person Interview NMHS OMB_PDF 02.pdf Form and Instruction
NMHS OMB_PDF 09.pdf In-Person Materials IC Document

Information Collection (IC) Details

IC Title:	In-Person Interview	Agency IC Tracking Number:

Is this a Common Form? No		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	In-Person Interview	In-Person Interview	NMHS OMB_PDF 02.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,200	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	1,200	1,200
Annual IC Time Burden (Hours)	1,300	1,300
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
In-Person Materials	NMHS OMB_PDF 09.pdf	07/10/2017

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