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![](https://webarchive.library.unt.edu/web/20090116190421im_/http://www.cdc.gov/navimages/spacer.gif) Questionnaires
Modules By Category (2006)
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Adult Asthma History (14) States | Idaho, Kentucky, Louisiana, Mississippi, Nevada, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Puerto Rico, Rhode Island, Utah, West Virginia | Anxiety and Depression (36) States | Alabama, Alaska, Arkansas, California, Delaware, District of Columbia, Florida, Georgia, Hawaii, Indiana, Iowa, Louisiana, Maine, Michigan, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Mexico, North Dakota, Oklahoma, Oregon, Puerto Rico, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virgin Islands, Virginia, West Virginia, Wisconsin, Wyoming | Child Influenza Vaccine Supplement (7) States | Missouri, Nevada, New Hampshire, Ohio, Vermont, West Virginia, Wisconsin | Childhood Asthma Prevalence (38) States | Alaska, Arizona, California, Connecticut, District of Columbia, Georgia, Hawaii, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, Texas, Utah, Vermont, Virginia, West Virginia, Wisconsin, Wyoming | Diabetes (44) States | Alabama, Alaska, Arizona, Arkansas, California, Colorado, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kentucky, Louisiana, Maine, Michigan, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virgin Islands, Virginia, Washington, West Virginia, Wyoming | Family Planning (7) States | Arizona, Kentucky, Minnesota, Missouri, Montana, Oregon, Wisconsin | Folic Acid (13) States | Delaware, Florida, Georgia, Kentucky, Minnesota, Missouri, Montana, New York, North Carolina, Puerto Rico, Virginia, Wisconsin, Wyoming | General Preparedness (3) States | Montana, Nevada, Tennessee | Healthy Days: Symptoms (4) States | Delaware, Hawaii, New York, Rhode Island | Home Environment (1) States | Idaho | Indoor Air Quality (1) States | Arizona | Intimate Partner Violence (8) States | Arkansas, Hawaii, Louisiana, Montana, Nevada, Virgin Islands, Virginia, West Virginia | Random Child Selection (39) States | Alaska, Arizona, California, Connecticut, District of Columbia, Georgia, Hawaii, Idaho, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Dakota, Texas, Utah, Vermont, Virginia, West Virginia, Wisconsin, Wyoming | Reactions to Race (2) States | Michigan, Wisconsin | Secondhand Smoke Policy (20) States | Alabama, Arizona, Arkansas, Georgia, Indiana, Iowa, Louisiana, Missouri, Nevada, New Hampshire, New Jersey, North Dakota, Ohio, Oklahoma, Pennsylvania, Virgin Islands, Virginia, West Virginia, Wisconsin, Wyoming | Sexual Violence (12) States | Florida, Hawaii, Idaho, Iowa, Maine, Montana, Nevada, New Hampshire, Utah, Virgin Islands, Virginia, Wisconsin | Visual Impairment and Access to Eye Care (8) States | Arizona, Connecticut, Florida, Georgia, New York, Ohio, Tennessee, Texas
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