Information Collection

NHIS 2007 Family Core Questionnaire

IC 45688 under ICR 200610-0920-005 · OMB 0920-0214.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form Not Assigned
Family Identification NHIS 2007 Family Core Questionnaire
Form and Instruction
Form Not Assigned
Family Health Insurance NHIS 2007 Family Core Questionnaire
Form and Instruction
Form Not Assigned
Family Identification NHIS 2007 Family Core Questionnaire
Form and Instruction
Form Not Assigned
Family Health Status and Limitations NHIS 2007 Family Core Questionnaire
Form and Instruction
Form Not Assigned
Family Injury and Poisoning NHIS 2007 Family Core Questionnaire
Form and Instruction
Form Not Assigned
Family Access to Health Care and Utilization NHIS 2007 Family Core Questionnaire
Form and Instruction
Form Not Assigned
Family Health Insurance NHIS 2007 Family Core Questionnaire
Form and Instruction
Form Not Assigned
Family Socio-Demographic NHIS 2007 Family Core Questionnaire
Form and Instruction
Form Not Assigned
Family Income NHIS 2007 Family Core Questionnaire
Form and Instruction
Form Not Assigned
Recontact NHIS 2007 Family Core Questionnaire
Form and Instruction
Not Assigned Family Identification
1-FIDupdated.doc
Form and Instruction
Not Assigned Family Health Insurance
5-FHIupdated.doc
Form and Instruction
Not Assigned Family Identification
1-FID.doc
Form and Instruction
Not Assigned Family Health Status and Limitations
2-FHS.doc
Form and Instruction
Not Assigned Family Injury and Poisoning
3-FIJ.doc
Form and Instruction
Not Assigned Family Access to Health Care and Utilization
4-FAU.doc
Form and Instruction
Not Assigned Family Health Insurance
5-FHI.doc
Form and Instruction
Not Assigned Family Socio-Demographic
6-FSD.doc
Form and Instruction
Not Assigned Family Income
7-FIN.doc
Form and Instruction
Not Assigned Recontact
8-FRecontact.doc
Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

layout table

Information Collection Instruments:
table that charts list of instruments
Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Not Assigned Family Health Insurance 5-FHIupdated.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
Form and Instruction Not Assigned Family Identification 1-FIDupdated.doc Yes Yes Printable Only
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

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 39,000 0 39,000 0 0 0
Annual IC Time Burden (Hours) 14,300 0 14,300 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
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.