Information Collection Request

National Health Interview Survey

ICR 202010-0920-003 · OMB 0920-0214 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-0214 Health Exam Form and Instruction New Available
Form 0920-0214 Adolescent Follow-back Survey Form and Instruction New Repair queued
Form 0920-0214 COVID-Related Questions Sample Adult 2019 Follow-back Form and Instruction Removed Available
Form 0920-0214 COVID-Related Questions Adult Family Member Form and Instruction Removed Available
Form 0920-0214 COVID-Related Questions Sample Adult Form and Instruction Removed Available
Form 0920-0214 Re-Interview Survey Form and Instruction Modified Available
Form 0920-0214 Methodological Projects Form and Instruction Modified Available
Form 0920-0214 Child Questionnaire Form and Instruction Modified Repair queued
Form 0920-0214 Adult Questionnaire Form and Instruction Modified Available
Form 0920-0214 Household Roster Form and Instruction Modified Available
Att 4e - 2020 Q3 NHIS 2020 Q3 COVID-19 Items - RANDS Evaluation.docx Supplementary Document Uploaded 2020-12-23 Available
Att 4d - 2020 Q3 NHIS 2020 Q3 COVID-19 Items - Preliminary analyses.docx Supplementary Document Uploaded 2020-12-23 Available
Att 2d - Program Response to the Public Comments to the 30-Day Federal Register Notice.docx Supplementary Document Uploaded 2020-12-23 Available
Att 3a - NHIS Survey Content Justification.pdf Supplementary Document Uploaded 2020-10-20 Available
Att 12b - Healthy People 2030 Objectives Slated for NHIS.pdf Supplementary Document Uploaded 2020-10-20 Available
Att 8 - Precision Tables - Sample Adult, Sample Child, Sample Adolescents.xlsx Supplementary Document Uploaded 2020-10-20 Available
Att 7b - 2021-2022 (AFS) - Concepts Measured Duplication and Proposed Uses of Data.docx Supplementary Document Uploaded 2020-10-20 Available
Att 7a - 2021-2022 Adolescent Follow-back Survey (AFS) - Content Summary and Field Dates.docx Supplementary Document Uploaded 2020-10-20 Available
Att 5b - 2021 NHIS Proposed New Content - Concepts Measured, Duplication, and Proposed Uses of Data.docx Supplementary Document Uploaded 2020-12-23 Available
Att 5a - 2021 NHIS Proposed New Content - Content Summary.docx Supplementary Document Uploaded 2020-10-20 Available
Att 4c - NHIS 2020 Q3 Emergency COVID-19 Items - OMB Approval.pdf Supplementary Document Uploaded 2020-10-20 Available
Att 4b - 2020 Q3 NHIS 2020 Q3 COVID-19 Items - Concepts Measured, Duplication, and Proposed Uses of the Data.docx Supplementary Document Uploaded 2020-10-20 Available
Att 4a - 2020 Q3 NHIS 2020 Q3 COVID-19 Items - Content Summary.docx Supplementary Document Uploaded 2020-10-20 Available
Att 3e - NHIS Sponsored Content Repeated Annually 2021, 2022, 2023.docx Supplementary Document Uploaded 2020-10-20 Repair queued
Att 3d - NHIS Annual and Rotating Core 2021, 2022, 2023 - Sample Child.docx Supplementary Document Uploaded 2020-10-20 Available
Att 3c - NHIS Annual and Rotating Core 2021, 2022, 2023 - Sample Adult.docx Supplementary Document Uploaded 2020-10-20 Available
Att 2c - Program Response to the Public Comments to the 60-Day Federal Register Notice.pdf Supplementary Document Uploaded 2020-10-20 Available
Att 10a - 2021 NHIS Advance Letter.pdf Supplementary Document Uploaded 2020-10-20 Available
Att 12a - 2022-2023 NHIS Potential Content Summary.docx Supplementary Document Uploaded 2020-10-20 Available
Att 11 - NHIS Human Subjects Clearance.pdf Supplementary Document Uploaded 2020-10-20 Available
Att 10d - 2021 NHIS Thank You Letter.pdf Supplementary Document Uploaded 2020-10-20 Repair queued
Att 10c - Supplemental Mailings.pdf Supplementary Document Uploaded 2020-10-20 Available
Att 10b - 2021 NHIS Brochure.pdf Supplementary Document Uploaded 2020-10-20 Available
Att 3f - NHIS Questionnaire Redesign Consultations.pdf Supplementary Document Uploaded 2020-10-20 Available
Att 3b - NHIS Snapshot 3 Year-Cycle Questionnaire Content and Periodicity.pdf Supplementary Document Uploaded 2020-10-20 Available
Att 2a - 60 Day Federal Register Notice 2020-07977.pdf Supplementary Document Uploaded 2020-10-14 Available
2021 NHIS SSB 2020-12-22-2020.docx Supporting Statement B Uploaded 2020-12-23 Available
2021 NHIS SSA 2020-12-22-2020.docx Supporting Statement A Uploaded 2020-12-23 Available
Att 1 - Legislative Mandates (Excerpts).pdf Supplementary Document Uploaded 2020-10-14 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
244155 Health Exam Form and Instruction New
244154 Adolescent Follow-back Survey Form and Instruction New
242299 COVID-Related Questions Sample Adult 2019 Follow-back Form and Instruction Removed
242298 COVID-Related Questions Adult Family Member Form and Instruction Removed
242297 COVID-Related Questions Sample Adult Form and Instruction Removed
229175 Re-Interview Survey Form and Instruction Modified
229173 Methodological Projects Form and Instruction Modified
229172 Child Questionnaire Form and Instruction Modified
229171 Adult Questionnaire Form and Instruction Modified
229170 Household Roster Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2023 36 Months From Approved 12/31/2020
107,700 0 122,579
42,845 0 49,893
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 107,700 122,579 0 19,250 -34,129 0
Annual Time Burden (Hours) 42,845 49,893 0 8,474 -15,522 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No