Information Collection

MEPS-HC Core Interview

IC 37877 under ICR 201412-0935-002 · OMB 0935-0118.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0118 can be found here:

Documents and Forms

Document Name Document Type
Form 1 MEPS-HC Core Interview Form
1 Attachment 1 -- MEPS-HC Section Summary and Changes Attachment 1 -- MEPS-HC Section Summary and Changes 9.23.2014.docx meps.ahrq.gov/mepsweb/survey_comp/survey_questionnaires.jsp Form
Attachment 2 -- HC About MEPS Booklet.docx Attachment 2 -- HC About MEPS Booklet IC Document
Attachment 3 -- HC Why is Participation in MEPS so Important.pdf Attachment 3 -- HC Why is Participation in MEPS so Important IC Document
Attachment 4 -- HC Policy Impact Award.doc Attachment 4 -- HC Policy Impact Award IC Document
Attachment 5 -- HC MEPS A Survey of Health Care Use and Spending.docx Attachment 5 -- HC MEPS A Survey of Health Care Use and Spending IC Document
Attachment 8 -- HC Data protection is word ONE with MEPS.doc Attachment 8 -- HC Data protection is word ONE with MEPS IC Document
Attachment 9 -- HC DVD Companion Booklet.docx Attachment 9 -- HC DVD Companion Booklet IC Document
Attachment 10 -- HC Respondent Recruitment DVD.docx Attachment 10 -- HC Respondent Recruitment DVD IC Document
Attachment 11 -- HC Important Information About Your Participation in MEPS.doc Attachment 11 -- HC Important Information About Your Participation in MEPS IC Document
Attachment 12 -- HC MEPS Data Example & FAQs.docx Attachment 12 -- HC MEPS Data Example & FAQs IC Document
Attachment 13 -- HC Respondent Letters, Postcards and Notes.docx Attachment 13 -- HC Respondent Letters, Postcards and Notes IC Document
Attachment 14 -- HC MEPS FAQs Brochure.docx Attachment 14 -- HC MEPS FAQs Brochure IC Document
Attachment 16 -- HC MEPS Record Keeper.pdf Attachment 16 -- HC MEPS Record Keeper IC Document
Attachment 17 -- HC Showcards 2013.doc Attachment 17 -- HC Showcards 2013 IC Document
Attachment 18 -- HC Validation Letter.doc Attachment 18 -- HC Validation Letter IC Document
Attachment 19 -- HC Certificate of Appreciation.docx Attachment 19 -- HC Certificate of Appreciation IC Document
Attachment 20 -- HC Who Uses MEPS Data.docx Attachment 20 -- HC Who Uses MEPS Data IC Document
Attachment 7 -- HC About the MEPS-MPC Authorization Form.zip Attachment 7 -- HC About the MEPS-MPC Authorization Form IC Document
Attachment 6 -- HC Statistical Brief Abstracts.zip Attachment 6 -- HC Statistical Brief Abstracts IC Document
Attachment 15 -- HC MEPS Monthly Planner 2013-2014.zip Attachment 15 -- HC MEPS Monthly Planner 2013-2014 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	MEPS-HC Core Interview	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Attachment 1 -- MEPS-HC Section Summary and Changes	Attachment 1 -- MEPS-HC Section Summary and Changes 9.23.2014.docx	http://meps.ahrq.gov/mepsweb/survey_comp/survey_questionnaires.jsp	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15,093	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	37,733	37,733
Annual IC Time Burden (Hours)	54,084	54,084
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.