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CHIS conducts separate surveys for three age groups: adults (18 years of age and older); adolescents (12 to 17 years of age); and children (birth to 12 years of age).
Insurance information for adolescents is collected from the adult respondent (CHIS 2003) or from a permission-giving adult (CHIS 2001). CHIS otherwise interviews adolescents directly about their own health and behaviors.
For children under 12 years of age, CHIS interviews the adult in the household who is most knowledgeable about that child's health.
The following are technical documents that contain the actual questionnaires used in the field, including question numbers and skip patterns.
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Adult Questionnaire (PDF, 822k) |
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Adolescent Questionnaire (PDF, 173k) |
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Child Questionnaire (PDF, 475k) |
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Adult Questionnaire (PDF, 1280k) |
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Adolescent Questionnaire (PDF, 426k) |
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Child Questionnaire (PDF, 477k) |
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Adult Questionnaire (PDF, 1769k) |
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Adolescent Questionnaire (PDF, 868k) |
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Child Questionnaire (PDF, 752k) |
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Adult Questionnaire (PDF, 733k) |
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Adolescent Questionnaire (PDF, 190k) |
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Adolescent Insurance Questionnaire (PDF, 76k) |
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Child Questionnaire (PDF, 269k) |
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CHIS-CAM Questionnaire (PDF, 111k) |
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