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#1 OMB # 09200237 NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY HOME INTERVIEW CONSENT Print name of person questioned First Middle Last You have been chosen to take part in the National Health

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What is household interview consent?

Household interview consent is a form that gives permission for someone to be interviewed or surveyed within their own household.

Who is required to file household interview consent?

Household interview consent is generally required from each member of the household who is being interviewed or surveyed.

How to fill out household interview consent?

To fill out household interview consent, individuals need to provide their personal information, acknowledge their consent for the interview or survey, and sign the form.

What is the purpose of household interview consent?

The purpose of household interview consent is to ensure that individuals are aware of and agree to participate in an interview or survey conducted within their household.

What information must be reported on household interview consent?

Household interview consent typically requires reporting personal information such as name, address, contact details, and demographic information of the household member being interviewed or surveyed.

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