Information Collection Request

[NCCDPHP] Behavioral Risk Factor Surveillance System (BRFSS)

ICR 202512-0920-004 · OMB 0920-1061 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
BRFSS Online Optional Modules Survey Instrument Form and Instruction Unchanged Available
BRFSS Optional Modules by Online Survey Form and Instruction Unchanged Repair queued
BRFSS Online Survey Instrument Form and Instruction Unchanged Available
BRFSS Core Survey by Online Survey Form and Instruction Unchanged Repair queued
Form 0920-1061 2022 Field Test Questionnaire Form and Instruction Unchanged Available
Form 0920-1061 Field Test Questionnaire Form and Instruction Unchanged Repair queued
Form 0920-1061 BRFSS Questionnaire (Field Test) Form and Instruction Unchanged Available
Form 0920-1061 Field Test - Screener Form and Instruction Unchanged Repair queued
Form 0920-1061 2026 BRFSS Questionnaire_09JAN2026 Form and Instruction Modified Repair queued
Form 0920-1061 2026 BRFSS Questionnaire Form and Instruction Modified Available
Form 0920-1061 BRFSS Questionnaire (OPTIONAL MODULES) Form and Instruction Modified Available
Form 0920-1061 BRFSS Questionnaire - (OPTIONAL MODULES) Form and Instruction Modified Repair queued
Form 0920-1061 2026 BRFSS Questionnaire_09JAN2026 Form and Instruction Modified Repair queued
Form 0920-1061 2026 BRFSS Questionnaire Form and Instruction Modified Available
Form 0920-1061 BRFSS Questionnaire (CORE SURVEY - Sections by Year) Form and Instruction Modified Available
Form 0920-1061 BRFSS Questionnaire (CORE SURVEY) Form and Instruction Modified Repair queued
Form 0920-1061 BRFSS Questionnaire (Cell Phone Screener) Form and Instruction Unchanged Available
Form 0920-1061 Cell Phone Screener Form and Instruction Unchanged Repair queued
Form 0920-1061 2024 BRFSS Questionnaire (Landline Screener) Form and Instruction Unchanged Available
Form 0920-1061 Landline Screener Form and Instruction Unchanged Repair queued
2026 BRFSS Change Request_20260108.docx Justification for No Material/Nonsubstantive Change Uploaded 2026-01-09 Available
2026 BRFSS Change Request_20251209.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-12-10 Repair queued
2026 BRFSS Change Request_20251209.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-12-10 Repair queued
2026 BRFSS Data Collection protocol 202501121.docx Supplementary Document Uploaded 2025-12-10 Available
2026 BRFSS Data Collection protocol 202501121.docx Supplementary Document Uploaded 2025-12-10 Repair queued
BRFSS IRB 2988 New Memo _20210107_Research Determination.docx Supplementary Document Uploaded 2024-12-02 Available
BRFSS IRB 2988 New Memo _20210107_Research Determination.docx Supplementary Document Uploaded 2024-12-02 Repair queued
BRFSS Attachment 17 - Example BRFSS Online Survey Instrument_compliant2.docx Supplementary Document Uploaded 2025-04-15 Available
BRFSS Attachment 17 - Example BRFSS Online Survey Instrument_compliant2.docx Supplementary Document Uploaded 2025-04-15 Repair queued
BRFSS Attachment 16 -Report on the Redesign of the Core Questionnaire_2025-2027.docx Supplementary Document Uploaded 2024-12-02 Available
BRFSS Attachment 16 -Report on the Redesign of the Core Questionnaire_2025-2027.docx Supplementary Document Uploaded 2024-12-02 Repair queued
BRFSS Attachment 15 BRFSS Modules by State and Split Samples_2025_2027 Cycle.docx Supplementary Document Uploaded 2024-12-02 Available
BRFSS Attachment 15 BRFSS Modules by State and Split Samples_2025_2027 Cycle.docx Supplementary Document Uploaded 2024-12-02 Repair queued
BRFSS Attachment 14 - BRFSS Crisis Protocol for Sensitive Questions_2025-2027 Cycle.docx Supplementary Document Uploaded 2024-12-02 Available
BRFSS Attachment 14 - BRFSS Crisis Protocol for Sensitive Questions_2025-2027 Cycle.docx Supplementary Document Uploaded 2024-12-02 Repair queued
BRFSS Attachment 13 Draft 2025 BRFSS Questionnaire_2025_2027 Cycle_compliant3.docx Supplementary Document Uploaded 2025-04-15 Repair queued
BRFSS Attachment 13 Draft 2025 BRFSS Questionnaire_2025_2027 Cycle_compliant3.docx Supplementary Document Uploaded 2025-04-15 Repair queued
BRFSS Attachment 12 Field Test for BRFSS Questionnaire_2025-2027_compliant2.docx Supplementary Document Uploaded 2025-04-15 Repair queued
BRFSS Attachment 12 Field Test for BRFSS Questionnaire_2025-2027_compliant2.docx Supplementary Document Uploaded 2025-04-15 Repair queued
BRFSS Attachment 11- Methods for BFRSS Question Adoption and Modfication_2025-2027.docx Supplementary Document Uploaded 2024-12-02 Available
BRFSS Attachment 11- Methods for BFRSS Question Adoption and Modfication_2025-2027.docx Supplementary Document Uploaded 2024-12-02 Repair queued
BRFSS Attachment 10 - 2024 BRFSS Data Collection Protocol with Disposition Table_2025-2027 Cycle_compliant2.docx Supplementary Document Uploaded 2025-04-15 Repair queued
BRFSS Attachment 10 - 2024 BRFSS Data Collection Protocol with Disposition Table_2025-2027 Cycle_compliant2.docx Supplementary Document Uploaded 2025-04-15 Repair queued
BRFSS Attachment 9 - BRFSS 2023 Summary Data Quality Report with Response Rates_2025-2027 Cycle.pdf Supplementary Document Uploaded 2024-12-02 Available
BRFSS Attachment 9 - BRFSS 2023 Summary Data Quality Report with Response Rates_2025-2027 Cycle.pdf Supplementary Document Uploaded 2024-12-02 Missing upstream
BRFSS Attachment 8 State Adult Population and BRFSS Sample Size 2023_2025_2027 Cycle.docx Supplementary Document Uploaded 2024-12-02 Repair queued
BRFSS Attachment 8 State Adult Population and BRFSS Sample Size 2023_2025_2027 Cycle.docx Supplementary Document Uploaded 2024-12-02 Missing upstream
BRFSS Attachment 7 BRFSS 2023 Weighting and Comparability Technical Documentation_2025_2027 Cycle_compliant2.docx Supplementary Document Uploaded 2025-04-15 Available
BRFSS Attachment 7 BRFSS 2023 Weighting and Comparability Technical Documentation_2025_2027 Cycle_compliant2.docx Supplementary Document Uploaded 2025-04-15 Repair queued
BRFSS Attachment 6a Federal Register Notice_2025_2027.pdf Supplementary Document Uploaded 2024-12-02 Available
BRFSS Attachment 6a Federal Register Notice_2025_2027.pdf Supplementary Document Uploaded 2024-12-02 Repair queued
BRFSS Attachment 5 Screening Scripts and Subject Recruitment_2025-2027 Cycle_compliant2.docx Supplementary Document Uploaded 2025-04-15 Repair queued
BRFSS Attachment 5 Screening Scripts and Subject Recruitment_2025-2027 Cycle_compliant2.docx Supplementary Document Uploaded 2025-04-15 Repair queued
BRFSS Attachment 4 Optional Modules by Topic_2025_2027 Updated_compliant3.docx Supplementary Document Uploaded 2025-04-15 Available
BRFSS Attachment 4 Optional Modules by Topic_2025_2027 Updated_compliant3.docx Supplementary Document Uploaded 2025-04-15 Repair queued
BRFSS Attachment 3- Core Questionnaire Sections by Year_2025-2027 Cycle_compliant2.docx Supplementary Document Uploaded 2025-04-15 Available
BRFSS Attachment 3- Core Questionnaire Sections by Year_2025-2027 Cycle_compliant2.docx Supplementary Document Uploaded 2025-04-15 Repair queued
BRFSS Attachment 2- List of BRFSS Awardees_2025-2027.docx Supplementary Document Uploaded 2024-12-02 Available
BRFSS Attachment 2- List of BRFSS Awardees_2025-2027.docx Supplementary Document Uploaded 2024-12-02 Repair queued
BRFSS Attachment 1 Authorizing Legislation [Section 301 of the Public Health Service Act (42 USC 241)].pdf Supplementary Document Uploaded 2024-12-02 Available
BRFSS Attachment 1 Authorizing Legislation [Section 301 of the Public Health Service Act (42 USC 241)].pdf Supplementary Document Uploaded 2024-12-02 Repair queued
BRFSS Supporting Statement A 2025-2027_final.docx Supporting Statement A Uploaded 2024-12-02 Available
BRFSS Supporting Statement A 2025-2027_final.docx Supporting Statement A Uploaded 2024-12-02 Available
BRFSS Supporting Statement B 2025-2027_compliant2.docx Supporting Statement B Uploaded 2025-04-15 Available
BRFSS Supporting Statement B 2025-2027_compliant2.docx Supporting Statement B Uploaded 2025-04-15 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
272762 BRFSS Optional Modules by Online Survey Form and Instruction UnchangedBRFSS Online Optional Modules Survey Instrument
272762 BRFSS Optional Modules by Online Survey Form and Instruction Unchanged
272761 BRFSS Core Survey by Online Survey Form and Instruction UnchangedBRFSS Online Survey Instrument
272761 BRFSS Core Survey by Online Survey Form and Instruction Unchanged
229653 Field Test Questionnaire Form and Instruction Unchanged2022 Field Test Questionnaire
229653 Field Test Questionnaire Form and Instruction Unchanged
229652 Field Test - Screener Form and Instruction UnchangedBRFSS Questionnaire (Field Test)
229652 Field Test - Screener Form and Instruction Unchanged
214640 BRFSS Questionnaire - (OPTIONAL MODULES) Form and Instruction Modified2026 BRFSS Questionnaire_09JAN2026
214640 BRFSS Questionnaire - (OPTIONAL MODULES) Form and Instruction Modified2026 BRFSS Questionnaire
214640 BRFSS Questionnaire - (OPTIONAL MODULES) Form and Instruction ModifiedBRFSS Questionnaire (OPTIONAL MODULES)
214640 BRFSS Questionnaire - (OPTIONAL MODULES) Form and Instruction Modified
214638 BRFSS Questionnaire (CORE SURVEY) Form and Instruction Modified2026 BRFSS Questionnaire_09JAN2026
214638 BRFSS Questionnaire (CORE SURVEY) Form and Instruction Modified2026 BRFSS Questionnaire
214638 BRFSS Questionnaire (CORE SURVEY) Form and Instruction ModifiedBRFSS Questionnaire (CORE SURVEY - Sections by Year)
214638 BRFSS Questionnaire (CORE SURVEY) Form and Instruction Modified
214637 Cell Phone Screener Form and Instruction UnchangedBRFSS Questionnaire (Cell Phone Screener)
214637 Cell Phone Screener Form and Instruction Unchanged
214636 Landline Screener Form and Instruction Unchanged2024 BRFSS Questionnaire (Landline Screener)
214636 Landline Screener Form and Instruction Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
04/30/2028 04/30/2028 04/30/2028
1,968,400 0 1,968,400
274,632 0 274,632
0 0 0





Reginfo record details
8
table that charts list of burden
IC Title Form No. Form Name
BRFSS Core Survey by Online Survey n/a
BRFSS Optional Modules by Online Survey n/a
BRFSS Questionnaire (CORE SURVEY) 0920-1061, 0920-1061, 0920-1061 ,   ,  
BRFSS Questionnaire - (OPTIONAL MODULES) 0920-1061, 0920-1061, 0920-1061 ,   ,  
Cell Phone Screener 0920-1061
Field Test - Screener 0920-1061
Field Test Questionnaire 0920-1061
Landline Screener 0920-1061

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 1,968,400 1,968,400 0 0 0 0
Annual Time Burden (Hours) 274,632 274,632 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No