Brfss questionnaire 2026

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The document is an appendix containing the Behavioral Risk Factor Surveillance System (BRFSS) questionnaire, which includes various sections assessing health status, quality of life, healthcare access, chronic health conditions, demographics, and lifestyle factors such as tobacco and alcohol use. It aims to gather data on health-related behaviors and conditions to inform public health initiatives.

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Click ‘Get Form’ to open the BRFSS questionnaire in the editor.
Begin with Section 1: Health Status. Select your general health status by choosing one of the options from excellent to poor.
Move to Section 2: Healthy Days. Enter the number of days in the past 30 where your physical and mental health was not good, using the provided fields.
In Section 3: Health Care Access, indicate whether you have health care coverage and provide details about your personal doctor if applicable.
Continue through Sections 4 to 15, answering questions regarding hypertension awareness, cholesterol awareness, chronic health conditions, and more. Use checkboxes and text fields as needed.
Finally, review all sections for accuracy before submitting your completed questionnaire.

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