Household Roster

[NCHS] National Health Interview Survey

OMB: 0920-0214

IC ID: 229170

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Household Roster 0920-0214
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None 2024 NHIS Roster Questionnaire Att 9a - 2024 NHIS Roster Questionnaire 10-24-2023.pdf Yes Yes Fillable Fileable
Form and Instruction 0920-0214 Household Roster NHIS_2025 Att 9a NHIS_ 2025 Roster.pdf N/A Yes Yes Fillable Fileable

Health Public Health Monitoring

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

36,000 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 36,000 0 0 0 0 36,000
Annual IC Time Burden (Hours) 2,400 0 0 0 0 2,400
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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