Attachment 15 – HC Validation Letter

Date:

Dear

On behalf of the Department of Health and Human Services, I thank you for participating in the Medical
Expenditure Panel Survey (MEPS). By being a participant in this important national research effort, you
are fulfilling a valuable public service.
As a member of the quality assurance team, it is my responsibility to see that all interviews are
completed according to study procedures. The questions on the enclosed form refer to your most
recent MEPS interview. Please answer these questions for me, and feel free to offer any comments
you may have about the interview or the interviewer.
Thank you for your time and participation in this important survey. Please return the form using the
enclosed postage-paid envelope.
Sincerely,

MEPS Quality Assurance Team

Encl (2)

RUID:
FIID:
Round:
13-305

Form Approved
OBM# 0935-0118
Exp. Date 12/31/2015

MEPS POST-INTERVIEW FORM
1. Approximately how long did your most recent MEPS interview take?
_____ HOURS AND _____ MINUTES
2. Were you interviewed in person or over the telephone?
IN PERSON

Comment: __________________________________

TELEPHONE (GO TO Q4)

___________________________________________
___________________________________________

3. Did the interviewer use a laptop computer to record your answers?
YES

Comment: __________________________________

NO (Please comment.)

___________________________________________
___________________________________________

4. Were you asked about everyone living in your household?
YES

Comment: __________________________________

NO (Please comment.)

___________________________________________

NOT APPLICABLE

___________________________________________

5. Did you receive a monetary gift from the interviewer at the end of the interview?
YES

5a. How much did you receive? ________________________________

NO
6. Did you receive any token gifts for your participation?
YES

6a. What gifts did you receive? _________________________________

NO
7. Was your interviewer courteous and professional?
YES

Comment: __________________________________

NO (Please comment.)

___________________________________________
___________________________________________

8. Please add any comments you have about the interview or the person who interviewed you.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

RUID:
FIID:
Round:
13-305