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ICR Documents

Document Date Uploaded
Supporting Statement Part A -- MEPS HC and MPC Through 2012 V2.doc 01/14/2010

Document Date Uploaded
Supporting Statement Part B -- MEPS HC and MPC Through 2012.doc 08/21/2009

Title Document Document Type Date Uploaded
Attachment 2 -- HC About MEPS Booklet Attachment 2 -- HC About MEPS Booklet.pdf Supplementary Document 08/21/2009
Attachment 3 -- HC About MEPS-MPC Permission Form Attachment 3 -- HC About MEPS-MPC Permission Form.doc Supplementary Document 08/21/2009
Attachment 4 -- HC Appointment Reminder Postcard Attachment 4 -- HC Appointment Reminder Postcard.pdf Supplementary Document 08/21/2009
Attachment 5 -- HC Community Authority Letter Attachment 5 -- HC Community Authority Letter.doc Supplementary Document 08/21/2009
Attachment 6 -- HC Data protection is word ONE with MEPS Attachment 6 -- HC Data protection is word ONE with MEPS.doc Supplementary Document 08/21/2009
Attachment 7 -- HC DVD Companion Booklet Attachment 7 -- HC DVD Companion Booklet.doc Supplementary Document 08/21/2009
Attachment 8 -- HC Respondent Recruitment DVD Attachment 8 -- HC Respondent Recruitment DVD.doc Supplementary Document 08/21/2009
Attachment 9 -- HC Important Information About Your Participation in MEPS Attachment 9 -- HC Important Information About Your Participation in MEPS.doc Supplementary Document 08/21/2009
Attachment 10 -- HC MEPS Change of Address Card Attachment 10 -- HC MEPS Change of Address Card.pdf Supplementary Document 08/21/2009
Attachment 11 -- HC MEPS Data Example & FAQs Attachment 11 -- HC MEPS Data Example & FAQs.doc Supplementary Document 08/21/2009
Attachment 12 -- HC Rd 1 Prenotification Letter Attachment 12 -- HC Rd 1 Prenotification Letter.doc Supplementary Document 01/14/2010
Attachment 13 -- HC Rd 1 Respondent Materials Cover Letter Attachment 13 -- HC Rd 1 Respondent Materials Cover Letter.doc Supplementary Document 01/14/2010
Attachment 14 -- HC Rd 3 Advance Letter 1 Attachment 14 -- HC Rd 3 Advance Letter 1.doc Supplementary Document 01/14/2010
Attachment 15 -- HC Rd 3 Advance Letter 2 Attachment 15 -- HC Rd 3 Advance Letter 2.doc Supplementary Document 01/14/2010
Attachment 16 -- HC Rd 5 Advance Letter 1 Attachment 16 -- HC Rd 5 Advance Letter 1.doc Supplementary Document 01/14/2010
Attachment 17 -- HC Rd 5 Advance Letter 2 Attachment 17 -- HC Rd 5 Advance Letter 2.doc Supplementary Document 01/14/2010
Attachment 18 -- HC Rds 2 & 4 Advance Letter Attachment 18 -- HC Rds 2 & 4 Advance Letter.doc Supplementary Document 01/14/2010
Attachment 19 -- HC MEPS FAQs Brochure Attachment 19 -- HC MEPS FAQs Brochure.doc Supplementary Document 08/21/2009
Attachment 20 -- HC MEPS Monthly Planner Attachment 20 -- HC MEPS Monthly Planner.pdf Supplementary Document 08/21/2009
Attachment 21 -- HC MEPS Record Keeper Attachment 21 -- HC MEPS Record Keeper.pdf Supplementary Document 08/21/2009
Attachment 23 -- HC Showcards Attachment 23 -- HC Showcards.doc Supplementary Document 08/21/2009
Attachment 24 -- HC Sorry I Missed You Note Attachment 24 -- HC Sorry I Missed You Note.pdf Supplementary Document 08/21/2009
Attachment 25 -- HC Thank You Note Attachment 25 -- HC Thank You Note.pdf Supplementary Document 08/21/2009
Attachment 26 -- HC Validation Letter Attachment 26 -- HC Validation Letter.doc Supplementary Document 01/14/2010
Attachment 27 -- HC Users of MEPS Data Handout Attachment 27 -- HC Users of MEPS Data Handout.doc Supplementary Document 08/21/2009
Attachment 22 -- HC MEPS-MPC Permission Form FAQs Attachment 22 -- HC MEPS-MPC Permission Form FAQs.doc Supplementary Document 08/21/2009
Attachment 79 -- MPC Home Health FAQs BROCHURE Attachment 79 -- MPC Home Health FAQs BROCHURE.doc Supplementary Document 08/24/2009
Attachment 77 -- MPC Home Health Contact Guide for Organizations Attachment 77 -- MPC Home Health Contact Guide for Organizations.doc Supplementary Document 08/24/2009
Attachment 78 -- MPC Home Health Cover Letter Attachment 78 -- MPC Home Health Cover Letter.doc Supplementary Document 08/24/2009
Attachment 80 -- MPC Home Health Fax Cover Sheet Attachment 80 -- MPC Home Health Fax Cover Sheet.doc Supplementary Document 08/24/2009
Attachment 81 -- MPC Home Health Fax or Mail Return Form Attachment 81 -- MPC Home Health Fax or Mail Return Form.doc Supplementary Document 08/24/2009
Attachment 82 -- MPC Home Health Instructions & Client Check List - FAX Version Attachment 82 -- MPC Home Health Instructions & Client Check List - FAX Version.doc Supplementary Document 08/24/2009
Attachment 83 -- MPC Home Health Instructions & Client Check List - Phone Version Attachment 83 -- MPC Home Health Instructions & Client Check List - Phone Version.doc Supplementary Document 08/24/2009
Attachment 81 -- MPC Home Health Fax or Mail Return Form Attachment 81 -- MPC Home Health Fax or Mail Return Form.doc Supplementary Document 08/24/2009
Attachment 78 -- MPC Home Health Cover Letter Attachment 78 -- MPC Home Health Cover Letter.doc Supplementary Document 08/24/2009
Attachment 79 -- MPC Home Health FAQs BROCHURE Attachment 79 -- MPC Home Health FAQs BROCHURE.doc Supplementary Document 08/24/2009
Attachment 80 -- MPC Home Health Fax Cover Sheet Attachment 80 -- MPC Home Health Fax Cover Sheet.doc Supplementary Document 08/24/2009
Attachment 83 -- MPC Home Health Instructions & Client Check List - Phone Version Attachment 83 -- MPC Home Health Instructions & Client Check List - Phone Version.doc Supplementary Document 08/24/2009
Attachment 82 -- MPC Home Health Instructions & Client Check List - FAX Version Attachment 82 -- MPC Home Health Instructions & Client Check List - FAX Version.doc Supplementary Document 08/24/2009
Attachment 85 -- MPC Office Based Cover Letter Attachment 85 -- MPC Office Based Cover Letter.doc Supplementary Document 08/24/2009
Attachment 86 -- MPC Office Based FAQs Brochure Attachment 86 -- MPC Office Based FAQs Brochure.doc Supplementary Document 08/24/2009
Attachment 87 -- MPC Office Based Fax Cover Sheet Attachment 87 -- MPC Office Based Fax Cover Sheet.doc Supplementary Document 08/24/2009
Attachment 88 -- MPC Office Based Fax or Mail Return Form Attachment 88 -- MPC Office Based Fax or Mail Return Form.doc Supplementary Document 08/24/2009
Attachment 89 -- MPC Office Based Instructions & Patient List - FAX Version Attachment 89 -- MPC Office Based Instructions & Patient List - FAX Version.doc Supplementary Document 08/24/2009
Attachment 90 -- MPC Office Based Instructions & Patient List - Phone Version Attachment 90 -- MPC Office Based Instructions & Patient List - Phone Version.doc Supplementary Document 08/24/2009
Attachment 91 -- MPC Office Based Contact Guide Attachment 91 -- MPC Office Based Contact Guide.doc Supplementary Document 08/24/2009
Attachment 93 -- MPC SBD Contact Guide Attachment 93 -- MPC SBD Contact Guide.doc Supplementary Document 08/24/2009
Attachment 94 -- MPC SBD Cover Letter Attachment 94 -- MPC SBD Cover Letter.doc Supplementary Document 08/24/2009
Attachment 95 -- MPC SBD FAQs Brochure Attachment 95 -- MPC SBD FAQs Brochure.doc Supplementary Document 08/24/2009
Attachment 96 -- MPC SBD Fax Cover Sheet Attachment 96 -- MPC SBD Fax Cover Sheet.doc Supplementary Document 08/24/2009
Attachment 97 -- MPC SBD Fax or Mail Return Form Attachment 97 -- MPC SBD Fax or Mail Return Form.doc Supplementary Document 08/24/2009
Attachment 98 -- MPC SBD Instructions & Patient List - Phone Version Attachment 98 -- MPC SBD Instructions & Patient List - Phone Version.doc Supplementary Document 08/24/2009
Attachment 100 -- MPC Hospital Contact Guide Attachment 100 -- MPC Hospital Contact Guide.doc Supplementary Document 08/24/2009
Attachment 101 -- MPC Hospital Cover Letter Attachment 101 -- MPC Hospital Cover Letter.doc Supplementary Document 08/24/2009
Attachment 102 -- MPC Hospital FAQs BROCHURE Attachment 102 -- MPC Hospital FAQs BROCHURE.DOC Supplementary Document 08/24/2009
Attachment 103 -- MPC Hospital Fax Cover Sheet Attachment 103 -- MPC Hospital Fax Cover Sheet.doc Supplementary Document 08/24/2009
Attachment 104 -- MPC Hospital Fax or Mail Return Form Attachment 104 -- MPC Hospital Fax or Mail Return Form.doc Supplementary Document 08/24/2009
Attachment 105 -- MPC Hospital Instructions & Patient Accounts Check List - FAX Version Attachment 105 -- MPC Hospital Instructions & Patient Accounts Check List - FAX Version.doc Supplementary Document 08/24/2009
Attachment 106 -- MPC Hospital Instructions & Patient Accounts Check List - Phone Version Attachment 106 -- MPC Hospital Instructions & Patient Accounts Check List - Phone Version.doc Supplementary Document 08/24/2009
Attachment 107 -- MPC Hospital Instructions & Patient Records Check List - Fax Version Attachment 107 -- MPC Hospital Instructions & Patient Records Check List - Fax Version.doc Supplementary Document 08/24/2009
Attachment 108 -- MPC Hospital Instructions & Patient Records Check List - Phone Version Attachment 108 -- MPC Hospital Instructions & Patient Records Check List - Phone Version.doc Supplementary Document 08/24/2009
Attachment 101 -- MPC Hospital Cover Letter Attachment 101 -- MPC Hospital Cover Letter.doc Supplementary Document 08/24/2009
Attachment 102 -- MPC Hospital FAQs BROCHURE Attachment 102 -- MPC Hospital FAQs BROCHURE.DOC Supplementary Document 08/24/2009
Attachment 103 -- MPC Hospital Fax Cover Sheet Attachment 103 -- MPC Hospital Fax Cover Sheet.doc Supplementary Document 08/24/2009
Attachment 104 -- MPC Hospital Fax or Mail Return Form Attachment 104 -- MPC Hospital Fax or Mail Return Form.doc Supplementary Document 08/24/2009
Attachment 105 -- MPC Hospital Instructions & Patient Accounts Check List - FAX Version Attachment 105 -- MPC Hospital Instructions & Patient Accounts Check List - FAX Version.doc Supplementary Document 08/24/2009
Attachment 106 -- MPC Hospital Instructions & Patient Accounts Check List - Phone Version Attachment 106 -- MPC Hospital Instructions & Patient Accounts Check List - Phone Version.doc Supplementary Document 08/24/2009
Attachment 107 -- MPC Hospital Instructions & Patient Records Check List - Fax Version Attachment 107 -- MPC Hospital Instructions & Patient Records Check List - Fax Version.doc Supplementary Document 08/24/2009
Attachment 108 -- MPC Hospital Instructions & Patient Records Check List - Phone Version Attachment 108 -- MPC Hospital Instructions & Patient Records Check List - Phone Version.doc Supplementary Document 08/24/2009
Attachment 113 -- MPC Pharmacy Contact Guide Attachment 113 -- MPC Pharmacy Contact Guide.doc Supplementary Document 08/24/2009
Attachment 114 -- MPC Pharmacy Cover Letter Attachment 114 -- MPC Pharmacy Cover Letter.doc Supplementary Document 08/24/2009
Attachment 115 -- MPC Pharmacy Instructions & Customer List - FAX Version Attachment 115 -- MPC Pharmacy Instructions & Customer List - FAX Version.doc Supplementary Document 08/24/2009
Attachment 116 -- MPC Pharmacy Instructions & Customer List - Phone Version Attachment 116 -- MPC Pharmacy Instructions & Customer List - Phone Version.doc Supplementary Document 08/24/2009
Attachment 117 -- MPC Pharmacy FAQs BROCHURE Attachment 117 -- MPC Pharmacy FAQs BROCHURE.doc Supplementary Document 08/24/2009
Attachment 118 -- MPC Pharmacy Fax Cover Sheet Attachment 118 -- MPC Pharmacy Fax Cover Sheet.doc Supplementary Document 08/24/2009
Attachment 119 -- MPC Pharmacy Fax or Mail Return Form Attachment 119 -- MPC Pharmacy Fax or Mail Return Form.doc Supplementary Document 08/24/2009
Attachment 1 -- Healthcare Research and Quality Act of 1999 Attachment 1 -- Healthcare Research and Quality Act of 1999.pdf Supplementary Document 08/21/2009
Attachment 121 -- MPC Announcement Attachment 121 -- MPC Announcement.doc Supplementary Document 08/24/2009
Attachment 120 -- 60 Day Federal Register Notice Attachment 120 -- 60 Day Federal Register Notice.pdf Supplementary Document 08/24/2009
Attachment 122 - Memo to OMB Memo to OMB.doc Supplementary Document 01/15/2010

Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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