NHIS 2007 Family Core Questionnaire

National Health Interview Survey

⚠️ Notice: This information collection may be referencing outdated material.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 Family Core Questionnaire Form and Instruction
Not Assigned Family Identification 1-FID.doc Form and Instruction
Not Assigned Family Health Status and Limitations 2-FHS.doc Form and Instruction
Not Assigned Family Injury and Poisoning 3-FIJ.doc Form and Instruction
Not Assigned Family Access to Health Care and Utilization 4-FAU.doc Form and Instruction
Not Assigned Family Health Insurance 5-FHI.doc Form and Instruction
Not Assigned Family Socio-Demographic 6-FSD.doc Form and Instruction
Not Assigned Family Income 7-FIN.doc Form and Instruction
Not Assigned Recontact 8-FRecontact.doc Form and Instruction

Information Collection (IC) Details

IC Title:	NHIS 2007 Family 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	Family Identification	1-FID.doc	Yes	Yes	Printable Only
Form and Instruction	Not Assigned	Family Health Status and Limitations	2-FHS.doc	Yes	Yes	Printable Only
Form and Instruction	Not Assigned	Family Injury and Poisoning	3-FIJ.doc	Yes	Yes	Printable Only
Form and Instruction	Not Assigned	Family Access to Health Care and Utilization	4-FAU.doc	Yes	Yes	Printable Only
Form and Instruction	Not Assigned	Family Health Insurance	5-FHI.doc	Yes	Yes	Printable Only
Form and Instruction	Not Assigned	Family Socio-Demographic	6-FSD.doc	Yes	Yes	Printable Only
Form and Instruction	Not Assigned	Family Income	7-FIN.doc	Yes	Yes	Printable Only
Form and Instruction	Not Assigned	Recontact	8-FRecontact.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: 30,000	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	30,000	30,000
Annual IC Time Burden (Hours)	11,500	11,500
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.