Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
NHIS 2007 Adult Core Questionnaire Modified 32000 9600 0 Form and Instruction Not Assigned Adult Identification
Form and Instruction Not Assigned Adult Health Behaviors
Form and Instruction Not Assigned Adult Health Status and Limitations
Form and Instruction Not Assigned Adult Socio-Demographic
Form and Instruction Not Assigned Adult Conditions
Form and Instruction Not Assigned Adult Access to Health Care and Utilization
Form and Instruction Not Assigned Adult AIDS Knowledge and Attitudes
NHIS 2007 Adult Topical Module Modified 32000 9600 0 Instruction
NHIS 2007 Child Core Questionnaire Modified 13000 1950 0 Form and Instruction Not Assigned Child Health Status and Limitations
Form and Instruction Not Assigned Child Access to Health Care and Utilization
Form and Instruction Not Assigned Child Identification
Form and Instruction Not Assigned Child Mental Health Brief Questionnaire
Form and Instruction Not Assigned Child Mental Health Services
Form and Instruction Not Assigned Child Influenza Immunization
NHIS 2007 Child Topical Module Modified 13000 1300 0 Form and Instruction Not Assigned Child Topical Module
NHIS 2007 Family Core Questionnaire Modified 39000 14300 0 Form and Instruction Not Assigned Family Identification
Form and Instruction Not Assigned Family Health Status and Limitations
Form and Instruction Not Assigned Family Injury and Poisoning
Form and Instruction Not Assigned Family Access to Health Care and Utilization
Form and Instruction Not Assigned Family Health Insurance
Form and Instruction Not Assigned Family Socio-Demographic
Form and Instruction Not Assigned Family Income
Form and Instruction Not Assigned Recontact
NHIS 2007 Reinterview Survey Modified 3250 271 0 Form and Instruction Not Assigned Reinterview Survey
NHIS 2007 Screener Questionnaire Modified 15000 1250 0 Form and Instruction None Assigned Screener Questionnaire
Form and Instruction None Assigned Screener Survey
Total burden requested under this ICR: 147250 38271 0  
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