Home care for health care providers questionnaire

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

OMB: 0935-0118

IC ID: 191101

Information Collection (IC) Details

View Information Collection (IC)

Home care for health care providers questionnaire
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Form #1 Home care for health care providers questionnaire Attachment 27 -- MPC Home Care for Health Care Providers Questionnaire.doc Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

465 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,023 0 156 0 0 2,867
Annual IC Time Burden (Hours) 252 0 13 0 0 239
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment 30 -- MPC Home Health Respondent Materials - FAX Version Attachment 30 -- MPC Home Health Respondent Materials - FAX Version.doc 09/24/2012
Attachment 31 -- MPC Home Health Respondent Materials - Phone Version Attachment 31 -- MPC Home Health Respondent Materials - Phone Version.doc 09/24/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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