MPC Contact Guide/Screening Call

Medical Expenditure Panel Survey - Household and Medical Provider Components

Documents and Forms

Document Name Document Type
Form 55 MPC Contact Guide/Screening Call Form and Instruction
55 MPC Contact Guide & Screening Call Attachment 55 -- MPC Contact Guide & Screening Call.docx Form and Instruction
55 MPC Contact Guide & Screening Call Attachment 55 -- MPC Contact Guide & Screening Call.docx Form and Instruction

Information Collection (IC) Details

IC Title:	MPC Contact Guide/Screening Call	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	55	MPC Contact Guide & Screening Call	Attachment 55 -- MPC Contact Guide & Screening Call.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 38,683	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	38,683	-16,075	54,758
Annual IC Time Burden (Hours)	3,224	-1,339	4,563
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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