Information Collection

NHIS 2007 Child Core Questionnaire

IC 45691 under ICR 200711-0920-006 · OMB 0920-0214.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0214 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Not Assigned Child Health Status and Limitations NHIS 2007 Child Core Questionnaire	Form and Instruction
Form Not Assigned Child Access to Health Care and Utilization NHIS 2007 Child Core Questionnaire	Form and Instruction
Form Not Assigned Child Identification NHIS 2007 Child Core Questionnaire	Form and Instruction
Form Not Assigned Child Mental Health Brief Questionnaire NHIS 2007 Child Core Questionnaire	Form and Instruction
Form Not Assigned Child Mental Health Services NHIS 2007 Child Core Questionnaire	Form and Instruction
Form Not Assigned Child Influenza Immunization NHIS 2007 Child Core Questionnaire	Form and Instruction
Not Assigned Child Health Status and Limitations 2-CHS.doc	Form and Instruction
Not Assigned Child Access to Health Care and Utilization 3-CAU.doc	Form and Instruction
Not Assigned Child Identification 1-CID.doc	Form and Instruction
Not Assigned Child Mental Health Brief Questionnaire 4-CMB.doc	Form and Instruction
Not Assigned Child Mental Health Services 5-CMS.doc	Form and Instruction
Not Assigned Child Influenza Immunization 6-CFI.doc	Form and Instruction

IC Title:

NHIS 2007 Child Core Questionnaire

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Not Assigned	Yes	Yes	Printable Only
Form and Instruction	Not Assigned	Yes	Yes	Printable Only
Form and Instruction	Not Assigned	Yes	Yes	Printable Only
Form and Instruction	Not Assigned	Yes	Yes	Printable Only
Form and Instruction	Not Assigned	Yes	Yes	Printable Only
Form and Instruction	Not Assigned	Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Health and Demographic Surveys Conducted in Probability Samples of the U.S. Population

FR Citation: 49 FR 37693

Number of Respondents: 13,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	13,000	13,000
Annual IC Time Burden (Hours)	1,950	1,950
Annual IC Cost Burden (Dollars)	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.

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