BRFSS Core Survey

2019 Field Test Behavioral Risk Factor Surveillance System (BRFSS)

OMB: 0920-1061

IC ID: 214638

Information Collection (IC) Details

View Information Collection (IC)

BRFSS Core Survey 0920-1061-18AXT
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1061 Even-Numbered Year BRFSS Core Questionnaire Attachment 3a Even- Numbered Year Core Questionnaire (2).docx NA Yes Yes Fillable Fileable
Form and Instruction 0920-1061 Odd-Numbered Year BRFSS Core Questionnaire Attachment 3b Odd-Numbered Year Core Questionnaire.docx NA Yes Yes Fillable Fileable
Form and Instruction none BRFSS Core Survey Attachment 5a 2021 BRFSS Questionnaire 10-21 cp.docx No   Paper Only

Health Public Health Monitoring

 

480,000 0
   
Individuals or Households
 
   0 %

  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 480,000 0 0 0 0 480,000
Annual IC Time Burden (Hours) 120,000 0 0 0 0 120,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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