Family Core (adult family member)

National Health Interview Survey

OMB: 0920-0214

IC ID: 45687

Documents and Forms
Document Name
Document Type
Other-Questionaire
Information Collection (IC) Details

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Family Core (adult family member)
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Questionaire Attachment 3a - Family Questionnaire Module.pdf Yes Yes Fillable Fileable

Health Immunization Management

Health and Demographic Surveys Conducted in Probability Samples of the U.S. Population  49 FR 37693

45,000 0
   
Individuals or Households
 
   100 %

  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 45,000 0 0 0 0 45,000
Annual IC Time Burden (Hours) 17,250 0 0 0 0 17,250
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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