Information Collection

Health Related Behaviors Survey

IC 259689 under ICR 202303-0720-002 · OMB 0720-0072.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2023 HRBS Annotated Survey_10.21 w Disclosure Notice.docx	Other-Survey
HRBS Survey_10.12.23.docx	Other-Survey
2022 HRBS Emails 1.24.22.pdf Health Related Behaviors Survey Emails	IC Document
Copy of 2024 HRBS Items 9.25.23.xlsx HRBS Items	IC Document
2024 HRBS Emails 10.12.23.docx Health Related Behaviors Survey Emails	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			HRBS Survey_10.12.23.docx		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 22,100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	22,100	22,100
Annual IC Time Burden (Hours)	7,367	7,367
Annual IC Cost Burden (Dollars)	209,333	209,333

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
HRBS Items	Copy of 2024 HRBS Items 9.25.23.xlsx	10/12/2023
Health Related Behaviors Survey Emails	2024 HRBS Emails 10.12.23.docx	10/12/2023

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