HC Adult SAQ that includes Mental Health Questions

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

OMB: 0935-0118

IC ID: 236894

Information Collection (IC) Details

View Information Collection (IC)

HC Adult SAQ that includes Mental Health Questions
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 106a Attachment 106a.REV_Female PSAQ with Mental Health Content Attachment 106a.REV_Female PSAQ with Mental Health Content_for OMB.pdf Yes Yes Fillable Fileable
Form and Instruction 106b Attachment106b.REV_Male PSAQ with Mental Health Content Attachment106b.REV_Male PSAQ with Mental Health Content_for OMB.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

20,476 0
   
Individuals or Households
 
   100 %

  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 20,476 0 0 0 0 20,476
Annual IC Time Burden (Hours) 1,194 0 0 0 0 1,194
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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