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

View Information Collection (IC)

NHIS 2007 Family Core Questionnaire
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Not Assigned Family Identification 1-FID.doc Yes Yes Printable Only
Form and Instruction Not Assigned Family Health Status and Limitations 2-FHS.doc Yes Yes Printable Only
Form and Instruction Not Assigned Family Injury and Poisoning 3-FIJ.doc Yes Yes Printable Only
Form and Instruction Not Assigned Family Access to Health Care and Utilization 4-FAU.doc Yes Yes Printable Only
Form and Instruction Not Assigned Family Health Insurance 5-FHI.doc Yes Yes Printable Only
Form and Instruction Not Assigned Family Socio-Demographic 6-FSD.doc Yes Yes Printable Only
Form and Instruction Not Assigned Family Income 7-FIN.doc Yes Yes Printable Only
Form and Instruction Not Assigned Recontact 8-FRecontact.doc Yes Yes Printable Only

Health Public Health Monitoring

Health and Demographic Surveys Conducted in Probability Samples of the U.S. Population  49 FR 37693

30,000 0
   
Individuals or Households
 
   100 %

  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 30,000 0 -9,000 0 0 39,000
Annual IC Time Burden (Hours) 11,500 0 -2,800 0 0 14,300
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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