NHIS 2007 Child Core Questionnaire

National Health Interview Survey 2007-2009

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form Not Assigned NHIS 2007 Child Core Questionnaire Form and Instruction
Not Assigned Child Health Status and Limitations 2-CHS.doc Form and Instruction
Not Assigned Child Access to Health Care and Utilization 3-CAU.doc Form and Instruction
Not Assigned Child Identification 1-CID.doc Form and Instruction
Not Assigned Child Mental Health Brief Questionnaire 4-CMB.doc Form and Instruction
Not Assigned Child Mental Health Services 5-CMS.doc Form and Instruction
Not Assigned Child Influenza Immunization 6-CFI.doc Form and Instruction

Information Collection (IC) Details

IC Title:	NHIS 2007 Child Core Questionnaire	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Not Assigned	Child Health Status and Limitations	2-CHS.doc	Yes	Yes	Printable Only
Form and Instruction	Not Assigned	Child Access to Health Care and Utilization	3-CAU.doc	Yes	Yes	Printable Only
Form and Instruction	Not Assigned	Child Identification	1-CID.doc	Yes	Yes	Printable Only
Form and Instruction	Not Assigned	Child Mental Health Brief Questionnaire	4-CMB.doc	Yes	Yes	Printable Only
Form and Instruction	Not Assigned	Child Mental Health Services	5-CMS.doc	Yes	Yes	Printable Only
Form and Instruction	Not Assigned	Child Influenza Immunization	6-CFI.doc	Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Health and Demographic Surveys Conducted in Probability Samples of the U.S. Population	FR Citation: 49 FR 37693

Number of Respondents: 13,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	13,000	13,000
Annual IC Time Burden (Hours)	1,950	1,950
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.