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OMB 0920-0237 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 and Nutrition Examination Survey NHANES held by the Centers for Disease Control and Prevention CDC. This research tells us about the health and nutrition of people in the United States. It combines an interview with a health exam* Our interviewer will ask questions about you and your family. Some...
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How to fill out National Health and Nutrition Examination Survey Home Interview Consent

01
Read the introduction carefully to understand the purpose of the survey.
02
Provide your name and contact information as required.
03
Indicate your willingness to participate by signing the consent form.
04
Fill out demographic information including age, gender, and ethnicity.
05
Review any questions or concerns you may have with the interviewer.
06
Make sure to keep a copy of the signed consent form for your records.

Who needs National Health and Nutrition Examination Survey Home Interview Consent?

01
Individuals selected to participate in the National Health and Nutrition Examination Survey.
02
Households that receive a notification for the survey.
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Using a list of houses, apartments, condos, and other households in the selected neighborhoods, NHANES randomly chooses a small number for the survey.
The National Health and Nutrition Examination Survey (NHANES) is designed to assess the health and nutritional status of adults and children in the United States. The survey is unique in that it combines interviews and physical examinations.
NHANES includes clinical examinations, selected medical and laboratory tests, and self-reported data. Home interviewers collect and encrypt data on laptops, use printed materials to prompt and verify responses, and verify prescription medicine use by examining container labels.
For NHANES Data National Center for Health Statistics (NCHS). National Health and Nutrition Examination Survey Data. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, [appropriate year][web URL].
Where can I find the data files and list of data items that are available from particular survey cycles in NHANES? Most of the NHANES data are publicly available and listed on the Questionnaires, Datasets, and Related Documentation page by survey cycle.
CDC's National Center for Health Statistics (NCHS) conducts NHANES. NHANES is the only national health survey that includes health exams, laboratory tests, and dietary interviews for participants of all ages. NHANES data can help improve the health of Americans.
NHANES uses a sampling strategy in which the “tails” of distributions are oversampled. For example, underrepresented groups are included at a disproportionately high rate. This ensures that they are well-modeled in the data.

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The National Health and Nutrition Examination Survey (NHANES) Home Interview Consent is a document that participants must sign to provide their consent for the NHANES team to conduct interviews and collect health and nutrition-related data during home visits.
Participants selected to be part of the NHANES study are required to file the Home Interview Consent. This includes individuals and their families who will take part in the interviews and assessments.
To fill out the NHANES Home Interview Consent, participants should read the consent form carefully, ensure they understand the information provided, and then sign and date the form as an indication of their agreement to participate in the survey.
The purpose of the NHANES Home Interview Consent is to ensure that participants are informed about the study procedures, their rights, and the use of the information collected, thereby enabling voluntary participation in the survey.
The information that must be reported on the NHANES Home Interview Consent includes the purpose of the survey, potential risks and benefits, confidentiality assurances, and contact information for questions or concerns regarding the study.
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