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![]() National Center for Chronic Disease Prevention and Health Promotion Behavioral Risk Factor Surveillance System ![]() BRFSS Home | Contact Us |
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Annual Self-Certification FormBRFSS, 2000 ___________________________ The following checklist is provided to assist you and your colleagues in your state in conducting BRFSS according to protocol and recommended practice. This checklist is intended to be completed in the month of February to help you assess the status of your methods for the current data collection year. Procedures that you are not personally involved with should be verified, not just assumed to be in effect. States that have a contractor should consult with their contractor to complete the form. References in parentheses at the end of each item refer to the User's Guide and Numbered Memos. Answer each item with "Yes" or "No." If you answer "No," provide an explanation (except for items 1.2, 4.1, and 4.6) Please complete the form using a word processor. Change the XX in the file name to your two character state abbreviation. Email a copy of the form to your Project Officer by March 6, 2000. Please also send a signed copy by mail to your Project Officer at:
If you have questions about any of these items, please contact your
Project Officer. |
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![]() 1 Before the Survey:
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![]() 2 Data collection staff have been directed:
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![]() 3 After each month’s survey:
*No explanation needed if "No"
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![]() * Links to non-Federal organizations are provided solely as a service to our users. Links do not constitute an endorsement of any organization by CDC or the Federal Government, and none should be inferred. The CDC is not responsible for the content of the individual organization Web pages found at this link.
Policies and Regulations | BRFSS Home | Contact Us Page last reviewed: 04/14/2008
United States Department of Health and Human Services |
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