Authorization Form for the MEPS-MPC Provider and Pharmacy Survey

Medical Expenditure Panel Survey - Household and Medical Provider Components

OMB: 0935-0118

IC ID: 204197

Documents and Forms

Document Name Document Type
Form 52 Authorization Form for the MEPS-MPC Provider and Pharmacy Survey Form and Instruction
52 Permission Form for Medical Providers Attachment 52 -- Permission Form for Medical Providers.pdf Form and Instruction
52 Permission Form for Medical Providers Attachment 52 -- Permission Form for Medical Providers.pdf Form and Instruction
53 Permission Form for Pharmacies Attachment 53 -- Permission Form for Pharmicies.pdf Form and Instruction
53 Permission Form for Pharmacies Attachment 53 -- Permission Form for Pharmicies.pdf Form and Instruction