BRFSS Core Survey

Behavioral Risk Factor Surveillance System (BRFSS)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1061 can be found here:

Documents and Forms

Document Name Document Type
BRFSS Core Survey Form
BRFSS Core Survey Attachment 3b-2015 Reference set of approved questions by core section.docx Form
Attachment 3a-Summary of all core sections.docx Summary of Core Sections IC Document

Information Collection (IC) Details

IC Title:	BRFSS Core Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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	BRFSS Core Survey	Attachment 3b-2015 Reference set of approved questions by core section.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 494,650	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	494,650	494,650
Annual IC Time Burden (Hours)	123,663	123,663
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Summary of Core Sections	Attachment 3a-Summary of all core sections.docx	01/14/2015

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