2021 Field Test Behavioral Risk Factor Surveillance System (BRFSS)

OMB 0920-1061

OMB 0920-1061

The BRFSS is a coordinated system of customized surveys conducted by U.S. states, territories, and the District of Columbia. Respondents are adults 18 years of age and older. Behavioral Risk Factor Surveillance System (BRFSS) surveys are conducted in collaboration with U.S. states, territories, and the District of Columbia. The surveys will produce state- or sub-state jurisdiction-level data about health-related risk behaviors, chronic health conditions, use of preventive services, and emerging health issues. CDC also creates a national level dataset that is used by HHS to evaluate its progress toward Healthy People 2020 goals and other policy needs. To ensure that BRFSS content is relevant to the current needs of BRFSS partners, CDC updates selected items in the core questionnaire and/or the optional modules on an annual basis. This Change Request is for edits to the core questionnaire approval to divide one module into three, and minor changes to the protocol with no change in burden.

The latest form for 2021 Field Test Behavioral Risk Factor Surveillance System (BRFSS) expires 2022-03-31 and can be found here.

Latest Forms, Documents, and Supporting Material
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Justification for No Material/Nonsubstantive Change
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Justification for No Material/Nonsubstantive Change
All Historical Document Collections
Revision of a currently approved collection 2021-10-07
Approved without change
No material or nonsubstantive change to a currently approved collection 2021-06-22
Approved without change
No material or nonsubstantive change to a currently approved collection 2020-11-10
Withdrawn and continue
No material or nonsubstantive change to a currently approved collection 2020-09-03
Approved without change
No material or nonsubstantive change to a currently approved collection 2019-08-05
Approved without change
No material or nonsubstantive change to a currently approved collection 2019-05-09
Approved with change
Revision of a currently approved collection 2019-02-08
Approved with change
No material or nonsubstantive change to a currently approved collection 2018-08-28
Withdrawn and continue
No material or nonsubstantive change to a currently approved collection 2018-08-10
Approved without change
No material or nonsubstantive change to a currently approved collection 2018-05-15
Approved with change
Revision of a currently approved collection 2018-01-10
Improperly submitted and continue
Revision of a currently approved collection 2017-12-14
Approved with change
No material or nonsubstantive change to a currently approved collection 2017-04-17
Approved with change
No material or nonsubstantive change to a currently approved collection 2016-09-27
Approved with change
No material or nonsubstantive change to a currently approved collection 2016-06-15
Approved with change
Revision of a currently approved collection 2016-04-21
Approved without change
No material or nonsubstantive change to a currently approved collection 2015-12-10
Approved with change
Existing collection in use without an OMB Control Number 2015-01-21
OMB Details

Landline Screener

Federal Enterprise Architecture: Health - Public Health Monitoring

Form 0920-1061BRFSS Landline Screen ScriptNAForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.


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