BRFSS Annual Survey Data
BRFSS Forms
One or more documents on this Web page is available in Portable Document Format
(PDF). You will need Acrobat
Reader to view and print these documents.
For detailed information on using these forms, please refer to the
BRFSS Operational and Users Guide.
BRFSS Protocol Self-Certification Form (2000)
The self-certification form is a tool to assist states to systematically
review conformity to standard BRFSS protocols and practices each year.
Interviewer
Monitoring Form (PDF–52K)
Monitoring is a valuable tool for ongoing training of interviewers and
achieving uniform questionnaire administration. Interviewers should be
monitored to ensure adherence to procedure, professional conduct,
effectiveness, and to identify areas for improvement. Monitoring is usually
done by a supervisor.
Verification Callback
Form (PDF–46K)
The purpose of Verification Callbacks (VCBs) is to ensure that the survey is
capturing consistent responses. This is an important quality control
procedure that measures the integrity of data collection. VCBs are usually
done by a supervisor or an experienced interviewer.
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