NCHS National Health and Nutrition Examination Survey (NHANES) line 1 NHANES questionnaire and examination

National Health and Nutrition Examination Survey (NHANES)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0237 can be found here:

Documents and Forms

Document Name Document Type
NCHS National Health and Nutrition Examination Survey (NHANES) line 1 NHANES questionnaire and examination Form
Questionnaire and MEC Data collection Forms Attachment 9 2011-12.doc Form

Information Collection (IC) Details

IC Title:	NCHS National Health and Nutrition Examination Survey (NHANES) line 1 NHANES questionnaire and examination	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Questionnaire and MEC Data collection Forms	Attachment 9 2011-12.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0164 Health and Demographic Surveys Conducted in Probability Samples of the US Population	FR Citation: 49 FR 37693

Number of Respondents: 18,813	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	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	18,813	0	0	0	0	0
Annual IC Time Burden (Hours)	37,626	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

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.