Information Collection Request

[NCHS] National Health Interview Survey

ICR 202303-0920-002 · OMB 0920-0214 · Active

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0920-0214 can be found here:

2026-01-28 - No material or nonsubstantive change to a currently approved collection
2025-09-22 - No material or nonsubstantive change to a currently approved collection

Forms and Documents

Document	Type	Status	Availability
Form 0920-22IA Health Exam	Form and Instruction	Unchanged	Available
Form 0920-22IA Health Exam	Form and Instruction	Unchanged	Repair queued
Form 0920-0214 Adolescent Follow-back Survey	Form and Instruction	Unchanged	Repair queued
Form 0920-0214 Adolescent Follow-back Survey	Form and Instruction	Unchanged	Repair queued
Re-Interview Survey	Form and Instruction	Unchanged	Available
Re-Interview Survey	Form and Instruction	Unchanged	Repair queued
Form 0920-0214 Methodological Projects	Form and Instruction	Unchanged	Available
Form 0920-0214 Methodological Projects	Form and Instruction	Unchanged	Repair queued
Child Questionnaire	Form and Instruction	Unchanged	Repair queued
Child Questionnaire	Form and Instruction	Unchanged	Repair queued
Adult Questionnaire	Form and Instruction	Modified	Available
Adult Questionnaire	Form and Instruction	Modified	Repair queued
Household Roster	Form and Instruction	Unchanged	Repair queued
Household Roster	Form and Instruction	Unchanged	Missing upstream
NHIS Nonsubstantive Change Request Q2 2023 02-27 FINAL.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-03-03	Available
NHIS Nonsubstantive Change Request Q2 2023 02-27 FINAL.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-03-03	Repair queued
Attachment 5b 2023 Q2 NHIS Proposed New Content - Concepts Measured, Duplication, and Proposed Uses of Data 02-13-2023.docx	Supplementary Document	Uploaded 2023-03-03	Repair queued
Attachment 5b 2023 Q2 NHIS Proposed New Content - Concepts Measured, Duplication, and Proposed Uses of Data 02-13-2023.docx	Supplementary Document	Uploaded 2023-03-03	Repair queued
Wilmot_2021_NCHS_NHIS_Child - has items on concussion.pdf	Supplementary Document	Uploaded 2022-10-26	Available
Wilmot_2021_NCHS_NHIS_Child - has items on concussion.pdf	Supplementary Document	Uploaded 2022-10-26	Missing upstream
Long Covid CCQDER BSC.potx	Supplementary Document	Uploaded 2022-10-26	Available
Long Covid CCQDER BSC.potx	Supplementary Document	Uploaded 2022-10-26	Repair queued
2023NHISEmergingContentSupplement.102622.docx	Supplementary Document	Uploaded 2022-10-26	Available
2023NHISEmergingContentSupplement.102622.docx	Supplementary Document	Uploaded 2022-10-26	Repair queued
Att 10 - Advance Lettter.pdf	Supplementary Document	Uploaded 2022-10-18	Repair queued
Att 10 - Advance Lettter.pdf	Supplementary Document	Uploaded 2022-10-18	Missing upstream
NHIS Nonsubstantive Change Request 2023 10-12-22Clean.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-10-18	Available
NHIS Nonsubstantive Change Request 2023 10-12-22Clean.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-10-18	Missing upstream
Att 8 - Precision Tables - Sample Adult, Sample Child, Sample Adolescents.xlsx	Supplementary Document	Uploaded 2022-10-18	Available
Att 8 - Precision Tables - Sample Adult, Sample Child, Sample Adolescents.xlsx	Supplementary Document	Uploaded 2022-10-18	Missing upstream
Att 5b - 2023 NHIS Proposed New Content - Concepts Measured Duplication and Proposed Use of Data 10-12-22Clean.docx	Supplementary Document	Uploaded 2022-10-18	Available
Att 5b - 2023 NHIS Proposed New Content - Concepts Measured Duplication and Proposed Use of Data 10-12-22Clean.docx	Supplementary Document	Uploaded 2022-10-18	Missing upstream
Att 5a - 2023 NHIS Proposed New Content - Concepts Measured_08-17-2022.docx	Supplementary Document	Uploaded 2022-10-18	Available
Att 5a - 2023 NHIS Proposed New Content - Concepts Measured_08-17-2022.docx	Supplementary Document	Uploaded 2022-10-18	Repair queued
Attachment 9b 2022 Q3 Additions to Sample Adult Questionnaire.docx	Supplementary Document	Uploaded 2022-05-03	Repair queued
Attachment 9b 2022 Q3 Additions to Sample Adult Questionnaire.docx	Supplementary Document	Uploaded 2022-05-03	Repair queued
Attachment 10c Supplemental Letter.pdf	Supplementary Document	Uploaded 2022-05-03	Repair queued
Attachment 10c Supplemental Letter.pdf	Supplementary Document	Uploaded 2022-05-03	Repair queued
Attachment 5b 2022 Q3 NHIS Proposed New Content Concepts Measured.docx	Supplementary Document	Uploaded 2022-05-03	Available
Attachment 5b 2022 Q3 NHIS Proposed New Content Concepts Measured.docx	Supplementary Document	Uploaded 2022-05-03	Missing upstream
NHIS Nonsubstantive Change Request Q3 2022 05-02-2022.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-05-03	Available
NHIS Nonsubstantive Change Request Q3 2022 05-02-2022.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-05-03	Repair queued
NHIS Nonsubstantive Change Request 2022 10-26-2021_clean.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2021-11-01	Available
NHIS Nonsubstantive Change Request 2022 10-26-2021_clean.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2021-11-01	Repair queued
NHIS Nonsubstantive Change Request 2021 Q2 COVID Vaccination Questions_2021-02-01.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2021-02-05	Available
NHIS Nonsubstantive Change Request 2021 Q2 COVID Vaccination Questions_2021-02-01.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2021-02-05	Repair queued
Att 4e - 2020 Q3 NHIS 2020 Q3 COVID-19 Items - RANDS Evaluation.docx	Supplementary Document	Uploaded 2020-12-23	Available
Att 4e - 2020 Q3 NHIS 2020 Q3 COVID-19 Items - RANDS Evaluation.docx	Supplementary Document	Uploaded 2020-12-23	Repair queued
Att 4d - 2020 Q3 NHIS 2020 Q3 COVID-19 Items - Preliminary analyses.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	Repair queued
Att 2d - Program Response to the Public Comments to the 30-Day Federal Register Notice.docx	Supplementary Document	Uploaded 2020-12-23	Repair queued
Att 2d - Program Response to the Public Comments to the 30-Day Federal Register Notice.docx	Supplementary Document	Uploaded 2020-12-23	Repair queued
Att 3a - NHIS Survey Content Justification.pdf	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 3a - NHIS Survey Content Justification.pdf	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 12b - Healthy People 2030 Objectives Slated for NHIS.pdf	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 12b - Healthy People 2030 Objectives Slated for NHIS.pdf	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 8 - Precision Tables - Sample Adult, Sample Child, Sample Adolescents.xlsx	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 7b - 2021-2022 (AFS) - Concepts Measured Duplication and Proposed Uses of Data.docx	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 7a - 2021-2022 Adolescent Follow-back Survey (AFS) - Content Summary and Field Dates.docx	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 7a - 2021-2022 Adolescent Follow-back Survey (AFS) - Content Summary and Field Dates.docx	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 5b - 2021 NHIS Proposed New Content - Concepts Measured, Duplication, and Proposed Uses of Data.docx	Supplementary Document	Uploaded 2020-12-23	Available
Att 5b - 2021 NHIS Proposed New Content - Concepts Measured, Duplication, and Proposed Uses of Data.docx	Supplementary Document	Uploaded 2020-12-23	Repair queued
Att 5a - 2021 NHIS Proposed New Content - Content Summary.docx	Supplementary Document	Uploaded 2020-10-20	Available
Att 5a - 2021 NHIS Proposed New Content - Content Summary.docx	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 4c - NHIS 2020 Q3 Emergency COVID-19 Items - OMB Approval.pdf	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	Repair queued
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 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	Repair queued
Att 4a - 2020 Q3 NHIS 2020 Q3 COVID-19 Items - Content Summary.docx	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 4a - 2020 Q3 NHIS 2020 Q3 COVID-19 Items - Content Summary.docx	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 3e - NHIS Sponsored Content Repeated Annually 2021, 2022, 2023.docx	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 3e - NHIS Sponsored Content Repeated Annually 2021, 2022, 2023.docx	Supplementary Document	Uploaded 2020-10-20	Available
Att 3d - NHIS Annual and Rotating Core 2021, 2022, 2023 - Sample Child.docx	Supplementary Document	Uploaded 2020-10-20	Available
Att 3d - NHIS Annual and Rotating Core 2021, 2022, 2023 - Sample Child.docx	Supplementary Document	Uploaded 2020-10-20	Missing upstream
Att 3c - NHIS Annual and Rotating Core 2021, 2022, 2023 - Sample Adult.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	Repair queued
Att 2c - Program Response to the Public Comments to the 60-Day Federal Register Notice.pdf	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 2c - Program Response to the Public Comments to the 60-Day Federal Register Notice.pdf	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 10a - 2021 NHIS Advance Letter.pdf	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 10a - 2021 NHIS Advance Letter.pdf	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 12a - 2022-2023 NHIS Potential Content Summary.docx	Supplementary Document	Uploaded 2020-10-20	Available
Att 12a - 2022-2023 NHIS Potential Content Summary.docx	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 11 - NHIS Human Subjects Clearance.pdf	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 11 - NHIS Human Subjects Clearance.pdf	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 10d - 2021 NHIS Thank You Letter.pdf	Supplementary Document	Uploaded 2020-10-20	Repair queued
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	Repair queued
Att 10c - Supplemental Mailings.pdf	Supplementary Document	Uploaded 2020-10-20	Missing upstream
Att 10b - 2021 NHIS Brochure.pdf	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 10b - 2021 NHIS Brochure.pdf	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 3f - NHIS Questionnaire Redesign Consultations.pdf	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 3f - NHIS Questionnaire Redesign Consultations.pdf	Supplementary Document	Uploaded 2020-10-20	Repair queued
Att 3b - NHIS Snapshot 3 Year-Cycle Questionnaire Content and Periodicity.pdf	Supplementary Document	Uploaded 2022-10-18	Available
Att 3b - NHIS Snapshot 3 Year-Cycle Questionnaire Content and Periodicity.pdf	Supplementary Document	Uploaded 2022-10-18	Repair queued
Att 2a - 60 Day Federal Register Notice 2020-07977.pdf	Supplementary Document	Uploaded 2020-10-14	Repair queued
Att 2a - 60 Day Federal Register Notice 2020-07977.pdf	Supplementary Document	Uploaded 2020-10-14	Repair queued
2021 NHIS SSB 2020-12-22-2020.docx	Supporting Statement B	Uploaded 2020-12-23	Available
2021 NHIS SSB 2020-12-22-2020.docx	Supporting Statement B	Uploaded 2020-12-23	Repair queued
2021 NHIS SSA 2020-12-22-2020.docx	Supporting Statement A	Uploaded 2020-12-23	Available
2021 NHIS SSA 2020-12-22-2020.docx	Supporting Statement A	Uploaded 2020-12-23	Repair queued
Att 1 - Legislative Mandates (Excerpts).pdf	Supplementary Document	Uploaded 2020-10-14	Available
Att 1 - Legislative Mandates (Excerpts).pdf	Supplementary Document	Uploaded 2020-10-14	Repair queued

IC Document Collections

IC ID	Collection	Type	Status
244155	Health Exam	Form and Instruction	Unchanged
244155	Health Exam	Form and Instruction	Unchanged
244154	Adolescent Follow-back Survey	Form and Instruction	Unchanged
244154	Adolescent Follow-back Survey	Form and Instruction	Unchanged
229175	Re-Interview Survey	Form and Instruction	Unchanged
229175	Re-Interview Survey	Form and Instruction	Unchanged
229173	Methodological Projects	Form and Instruction	Unchanged
229173	Methodological Projects	Form and Instruction	Unchanged
229172	Child Questionnaire	Form and Instruction	Unchanged
229172	Child Questionnaire	Form and Instruction	Unchanged
229171	Adult Questionnaire	Form and Instruction	Modified
229171	Adult Questionnaire	Form and Instruction	Modified
229170	Household Roster	Form and Instruction	Unchanged
229170	Household Roster	Form and Instruction	Unchanged

ICR Details

Status	Active
Agency/Subagency	HHS/CDC
OMB Control No	0920-0214
Type of Information Collection	No material or nonsubstantive change to a currently approved collection
Previous ICR Reference No	202210-0920-008
Agency Tracking No	0920-0214-23DB
Date Submitted to OIRA	2023-03-03
Requested Expiration Date	1969-12-31