Adult Questionnaire

[NCHS] National Health Interview Survey

OMB: 0920-0214

IC ID: 229171

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Adult Questionnaire 0920-22IA
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None 2023 NHIS Sample Adult Questionnaire Att 9b - 2023 NHIS Sample Adult Questionnaire.101322.pdf Yes Yes Fillable Fileable
Other-WORD Attachment 9b 2023 Q2 Additions to Sample Adult Questionnaire 02-13-2023.docx No   Paper Only

Health Public Health Monitoring

09-20-0164 Health and Demographic Surveys Conducted in Probability Samples of the U.S. Population  49 FR 37693

30,000 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 30,000 0 0 0 0 30,000
Annual IC Time Burden (Hours) 22,500 0 0 0 0 22,500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Additional COVID Questions Att 1 - 2021 Sample Adult Covid-19 Vaccination Questions.pdf 02/05/2021
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