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Attachment 19 – HC Adult SAQ – Male
Medical Expenditure Panel Survey - Household and Medical Provider Components
OMB: 0935-0118
IC ID: 230227
OMB.report
HHS/AHRQ
OMB 0935-0118
ICR 202401-0935-001
IC 230227
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0118 can be found here:
2024-07-02 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form Attachment 19
Attachment 19 – HC Adult SAQ – Male
Form and Instruction
Attachment 19 Attachment 19 – HC Adult SAQ – Male
Attachment 19 HC Adult SAQ Male.docx
Form and Instruction
Attachment 18 Attachment 18 HC Adult SAQ
Attachment 18 HC Adult SAQ.pdf
Form and Instruction
Information Collection (IC) Details
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