Authorization form for the MEPS-MPC Provider Survey

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

OMB: 0935-0118

IC ID: 204197

Information Collection (IC) Details

View Information Collection (IC)

Authorization form for the MEPS-MPC Provider Survey
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Form #1 Authorization Form for the MEPS-MPC - Provider 22-HC Authorization Form for the MEPS-MPC - Provider.doc Yes Yes Fillable Fileable

Health Immunization Management

 

14,489 0
   
Individuals or Households
 
   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 78,241 0 0 0 0 78,241
Annual IC Time Burden (Hours) 3,912 0 0 0 0 3,912
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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