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1. Medical Expenditure Panel Survey Survey Questionnaires
   meps.ahrq.gov/mepsweb/survey_comp/survey.jsp
   July 18, 2025 - measures of health status: the Veteran's RAND 12-item (VR-12) (in 2017 this replaces the Short-Form … The most current data years of the authorization forms are available below. … ; they sign the English forms. … Forms All Authorization Forms Medical Provider Authorization Form Medical Provider Authorization … Form - Spanish Pharmacy Authorization Form Pharmacy Authorization Form - Spanish Years

2. Medical Expenditure Panel Survey Survey Questionnaires
   meps.ahrq.gov/survey_comp/survey.jsp
   July 18, 2025 - measures of health status: the Veteran's RAND 12-item (VR-12) (in 2017 this replaces the Short-Form … The most current data years of the authorization forms are available below. … ; they sign the English forms. … Forms All Authorization Forms Medical Provider Authorization Form Medical Provider Authorization … Form - Spanish Pharmacy Authorization Form Pharmacy Authorization Form - Spanish Years

3. Medical Expenditure Panel Survey Home
   meps.ahrq.gov/mepsweb/
   January 01, 2024 - the Contact Guide to generate packages of materials, such as copies of signed patient authorization forms … MPC staff use these forms to collect information during telephone calls with providers or by abstracting … There are separate forms for each provider type: Home Care Health Care Providers, Home Care Non-Health … Survey Instruments The MPC Authorization Forms for 2023 have been posted. … Authorization forms are signed by patients interviewed by MEPS and permit MPC staff to contact medical

4. Medical Expenditure Panel Survey Home
   meps.ahrq.gov/mepsweb/index.jsp
   January 01, 2024 - the Contact Guide to generate packages of materials, such as copies of signed patient authorization forms … MPC staff use these forms to collect information during telephone calls with providers or by abstracting … There are separate forms for each provider type: Home Care Health Care Providers, Home Care Non-Health … Survey Instruments The MPC Authorization Forms for 2023 have been posted. … Authorization forms are signed by patients interviewed by MEPS and permit MPC staff to contact medical

5. Methodology Report #1: Design and Methods of the Medical Expenditure Panel Survey Household Component
   meps.ahrq.gov/data_files/publications/mr1/mr1.shtml
   December 31, 1997 - New hybrid forms of health insurance coverage also have appeared. … Medical Provider Permission Forms Signed permission forms are requested in Round 1, … a previous methodological study suggested that early requests for signed permission forms … In Round 2 and subsequent rounds, requests for signed permission forms apply to all types … Health Insurance Permission Forms Signed permission forms are needed to contact sources

6. Sample Design of the 2020 Medical Expenditure Panel Survey Insurance Component (pdf file)
   meps.ahrq.gov/data_files/publications/mr34/mr34.pdf
   August 01, 2021 - Survey forms were not mailed to the employer’s location if no contact was made. … The letter requests that completed survey forms be returned within 30 days. … The employers are offered the choice of responding either by completing the paper form and returning … Forms were also mailed later in the summer. 3 4. … TFU is conducted using CATI (computer assisted telephone interviewing) as well as using paper forms

7. Methodology Report #34: Sample Design of the 2020 Medical Expenditure Panel Survey Insurance Component
   meps.ahrq.gov/data_files/publications/mr34/mr34.shtml
   August 01, 2021 - If no contact is made with the employer during the prescreener, survey forms are … The letter requests that completed survey forms be returned within 30 days. … employers are offered the choice of responding either by completing the paper form … During this procedure Census staff attempt to hand-edit the data using paper forms … If the employer does not respond to the mailed survey forms, or fails to provide

8. Methodology Report #1: Design and Methods of the Medical Expenditure Panel Survey Household Component (pdf file)
   meps.ahrq.gov/data_files/publications/mr1/mr1.pdf
   December 31, 1997 - Many information products have an electronic ordering form and are mailed free of charge from the AHCPR … The HC is the core survey, and it forms the basis for the MPC sample and part of the IC sample. … New hybrid forms of health insurance coverage also have appeared. … Medical Provider Permission Forms Signed permission forms are requested in Round 1, much earlier than … Health Insurance Permission Forms Signed permission forms are needed to contact sources of employment

9. MEPS
   meps.ahrq.gov/communication/participants/faq_gen_pharm.shtml
   What should be done with the Authorization Forms? 10. … What should be done with the Authorization Forms? … There is no study requirement that you keep the authorization forms

10. MEPS
    meps.ahrq.gov/communication/participants/faq_gen_mpc.shtml
    What should be done with the Authorization Forms? 10. … What should be done with the Authorization Forms? … There is no study requirement that you keep the authorization forms.

11. Microsoft Word - HOSP EVENT FORM 2006 _legal_.doc (pdf file)
    meps.ahrq.gov/survey_comp/misc_survey/mpc/2006/HSP_06.pdf
    January 01, 2006 - Microsoft Word - HOSP EVENT FORM 2006 _legal_.doc OMB#: 0935-0118 PATIENT … LABEL |__|__|__| OFFICE USE ONLY |__|__|__| OFFICE USE ONLY FORM … MEDICAL EXPENDITURE PANEL SURVEY MEDICAL PROVIDER COMPONENT HOSPITAL EVENT FORM … FOR REFERENCE YEAR 2006 2 HOSPITAL EVENT FORM [COMPLETE ONE FORM FOR EACH EVENT] … [RECORD NAMES ON SEPARATELY BILLING DOCTOR FORM.

12. Survey Questionnaires
    meps.ahrq.gov/mepsweb/survey_comp/survey_questionnaires.jsp
    August 26, 2009 - government questionnaires Medical Provider Component Questionnaires Contact Guides Authorization Forms

13. Methodology Report 2023 Data Collection (pdf file)
    meps.ahrq.gov/data_files/publications/annual_contractor_report/mpc_ann_cntrct_methrpt.pdf
    May 01, 2025 - in the Institution Event Form, for use when the POC asked for a definition. … Event Forms Event Forms were used for collecting information either during telephone calls with providers … As each Event Form was completed, it was checked for critical items and, if missing, the Form was flagged … Dosage Form Range of Forms & Other Specify Q2e 5. … Rule Name Status Description Tagged form fields Passed All form fields are tagged Field descriptions

14. Medical Expenditure Panel Survey Medical Provider Component Response Rates
    meps.ahrq.gov/mepsweb/survey_comp/mpc_response_rate.jsp
    August 15, 2017 - Refusal rates include unwillingness to accept signed permission forms.

15. Medical Expenditure Panel Survey What's New
    meps.ahrq.gov/mepsweb/communication/whats_new.jsp
    August 08, 2025 - 2023 Household Component Survey Questionnaires | posted on 07/18/2025 2023 MPC Authorization Forms

16. MEPS Annual Methodology Report - Medical Provider Component (MEPS-MPC)
    meps.ahrq.gov/data_files/publications/annual_contractor_report/mpc_ann_cntrct_methrpt.shtml
    May 01, 2025 - in the Institution Event Form, for use when the POC asked for a definition. … A Quantity Units (N_QTYUNIT) item was added to the NDC path within the Pharmacy Event Form. … If an invalid modifier is entered into the Event Form field (MCPT), the system would display an error … Event Forms Event Forms were used for collecting information either during telephone calls with providers … As each Event Form was completed, it was checked for critical items and, if missing, the Form was flagged

17. Medical Expenditure Panel Survey Medical Provider Component Overview
    meps.ahrq.gov/mepsweb/survey_comp/mpc.jsp
    August 23, 2017 - collection in the Medical Provider Component: Contact guides Survey questionnaires Authorization Forms

18. MEPS
    meps.ahrq.gov/communication/participants/confidentialitypharm.shtml
    Such information may not be published or released in other form if the person who supplied the information … consent is documented through the patient’s signature on the MEPS authorization form … The MEPS authorization form (PDF 202 KB, or HTM 6 KB) was redesigned … in 2002 to meet the HIPAA requirements for authorization forms described in Section 164.508(c) 45 … The revised form was reviewed and deemed HIPAA compliant by the Westat IRB.

19. MEPS
    meps.ahrq.gov/communication/participants/confidentialitymcp.shtml
    Such information may not be published or released in other form if the person who supplied the information … This consent is documented through the patient’s signature on the MEPS authorization form … The MEPS authorization form was redesigned in 2002 to meet the HIPAA requirements for … authorization forms described in Section 164.508(c) 45 CFR 164. … The revised form was reviewed and deemed HIPAA compliant by the Westat IRB.

20. Hlthstat (pdf file)
    meps.ahrq.gov/data_stats/nhc/hlthstat.pdf
    September 30, 1997 - Ranges for determining the validity of the assessment dates for MDS forms are displayed below. … If there are two or more forms completed in the same month and only one has 5 a DAY entry, the form … If no forms dated in the same month have a DAY entry, none are eligible to use as the primary form for … Identify the forms by a “M” or “Q” preceding the section fills. … I am prepared to abstract from the medical record and MDS forms myself.