Information Collection

NHIS 2007 Family Core Questionnaire

IC 45688 under ICR 200808-0920-005 · 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⚠️ Notice: This information collection may be referencing outdated material.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 NHIS 2007 Family Core Questionnaire	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

IC Title:

NHIS 2007 Family 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.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
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
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

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: 30,000

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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	30,000	-9,000	39,000
Annual IC Time Burden (Hours)	11,500	-2,800	14,300
Annual IC Cost Burden (Dollars)	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.