Hospitals questionnaire

Medical Expenditure Panel Survey Household Component and Medical Provider Component (MEPS-HC and MEPS-MPC through 2009)

OMB: 0935-0118

IC ID: 191105

Documents and Forms

Document Name Document Type
Form Form #10 Hospitals questionnaire Form and Instruction
Form #10 Hospitals questionnaire Attachment 99 -- MPC Hospital Questionnaire.doc Form and Instruction
Attachment 100 -- MPC Hospital Contact Guide.doc Attachment 100 -- MPC Hospital Contact Guide IC Document
Attachment 101 -- MPC Hospital Cover Letter.doc Attachment 101 -- MPC Hospital Cover Letter IC Document
Attachment 102 -- MPC Hospital FAQs BROCHURE.DOC Attachment 102 -- MPC Hospital FAQs BROCHURE IC Document
Attachment 103 -- MPC Hospital Fax Cover Sheet.doc Attachment 103 -- MPC Hospital Fax Cover Sheet IC Document
Attachment 104 -- MPC Hospital Fax or Mail Return Form.doc Attachment 104 -- MPC Hospital Fax or Mail Return Form IC Document
Attachment 105 -- MPC Hospital Instructions & Patient Accounts Check List - FAX Version.doc Attachment 105 -- MPC Hospital Instructions & Patient Accounts Check List - FAX Version IC Document
Attachment 106 -- MPC Hospital Instructions & Patient Accounts Check List - Phone Version.doc Attachment 106 -- MPC Hospital Instructions & Patient Accounts Check List - Phone Version IC Document
Attachment 107 -- MPC Hospital Instructions & Patient Records Check List - Fax Version.doc Attachment 107 -- MPC Hospital Instructions & Patient Records Check List - Fax Version IC Document
Attachment 108 -- MPC Hospital Instructions & Patient Records Check List - Phone Version.doc Attachment 108 -- MPC Hospital Instructions & Patient Records Check List - Phone Version IC Document