Did you know?
CHIS 2007 includes new survey questions on HPV (Human Papilloma Virus), high-deductible health insurance plans and access to safe parks, among other topics.
CHIS Questionnaires:
CHIS surveys tens of thousands of Californians on dozens of health topics. Separate surveys are conducted 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.
You can also see what CHIS health topics change - and what stay the same - in What topics are covered by CHIS?
Click on any of the following links to see questionnaires for that year's survey:
CHIS 2007 |
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Adult Questionnaire (PDF, 822k) |
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Adolescent Questionnaire (PDF, 173k) |
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Child Questionnaire (PDF, 475k) |
CHIS 2005 |
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Adult Questionnaire (PDF, 1280k) |
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Adolescent Questionnaire (PDF, 426k) |
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Child Questionnaire (PDF, 477k) |
CHIS 2003 |
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Adult Questionnaire (PDF, 1769k) |
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Adolescent Questionnaire (PDF, 868k) |
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Child Questionnaire (PDF, 752k) |
CHIS 2001 |
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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) |
