View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

NHIS Follow-up Health Study 0920-1208-21DP
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1208 NHIS Follow-up Health Study Invitation to Participate Questions Attachment 1c - Invitation questions and help screen.docx No   Fillable Fileable
Instruction Attachment 1e - Appointment Scheduling and Reminders.docx No   Fillable Fileable
Form and Instruction 0920-1208 Home Health Visit Data Collection Forms Attachment 1i - Main Data Collection Forms.docx No   Fillable Fileable

Health Public Health Monitoring

 

1,500 0
   
Individuals or Households
 
   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 1,500 0 1,500 0 0 0
Annual IC Time Burden (Hours) 1,170 0 1,170 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Response to exams after surveys Attachment 1a - Response to Exams After Surveys_clean.docx 03/03/2021
COVID-19 Safety Precautions Attachment 1b - COVID Safety Precautions.docx 03/03/2021
Respondent Brochure Attachment 1d - Respondent brochure.docx 03/03/2021
Respondent conversion letter and brochure Attachment 1f - Respondent conversion letter and brochure.docx 03/03/2021
Health Measurements and Laboratory Tests on Blood & Urine Attachment 1g - MeasuresLabTestHandoutCOVIDHandout.docx 03/03/2021
HOME VISIT CONSENT Attachment 1h - Consent Form.docx 03/03/2021
Home Health Visit Data Collection Forms Attachment 1j - Initial Report.docx 03/03/2021
Final Report of Findings Attachment 1k- Final Report.docx 03/03/2021
NCHS Ethics Review Board (ERB) Approval Attachment 2 - NCHS Ethics Review Board (ERB) Approval .docx 03/03/2021
National Health Interview Survey (NHIS) Follow-up Health Study NHIS FHS Supporting Statement A_Feb26.docx 03/03/2021
National Health Interview Survey (NHIS) Follow-up Health Study NHIS FHS Supporting Statement B_Feb26.docx 03/03/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.