ICR Documents

Supporting Statement A Document Date Uploaded Supporting Statement Part A -- MEPS HC and MPC Through 2012 V2.doc 01/14/2010 Supporting Statement B Document Date Uploaded Supporting Statement Part B -- MEPS HC and MPC Through 2012.doc 08/21/2009 Supplementary Documents 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 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received