Native Hawaiian Pacific Islander

National Health Interview Survey: Native Hawaiian/Pacific Islander Survey

OMB No. 0920-0214 Approval Expires 03/31/2016

Assurance of Confidentiality (NOTICE): Information contained on this form which would permit identification of any individual or establishment has been collected with a guarantee that it will be held in strict confidence, will be used for statistical purposes only, and will not be disclosed or released to others without the consent of the individual or establishment in accordance with Section 308(d) of the Public Health Service Act (42 USC 242m) and the Confidential Information Protection and Statistical Efficiency Act (44 USC 3501 note).

Congress authorized the NHIS data collection in Section 306 of the Public Health Service Act (42 USC 242m(d)) and the Confidential Information Protection and Statistical Efficiency Act (PL 107-347). If any federal employee, contractor, or agent gives out confidential information no authorized by law, he or she can be fired, fined and/or imprisoned.

Public reporting burden of this collection of information is estimated to average about 60 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports, Clearance Officer; Paperwork Reduction Project (0920-0214), 1600 Clifton Rd., MS D-74, Atlanta, GA 30333.

The Native Hawaiian/Pacific Islander National Health Interview Survey (NHPI NHIS) uses the 2014 NHIS questionnaire in its entirety with the exception of questions about the last 4 digits of the Social Security and Medicare numbers and immunization provider contact since no linkage or provider record check will be conducted on this sample.