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1997 HOSPITAL EVENT QUEX - Medical Expenditure Panel Survey
Get 1997 HOSPITAL EVENT QUEX - Medical Expenditure Panel Survey
FORM OF MEDICAL EXPENDITURE PANEL SURVEY MEDICAL PROVIDER SURVEY HOSPITAL EVENT FORM REFERENCE YEAR 1997 HOSPITAL EVENT FORM COMPLETE ONE FORM FOR EACH EVENT QUESTIONS 1 THROUGH 4: TO BE COMPLETED WITH MEDICAL RECORDS. READ ONLY FOR FIRST EVENT FOR THIS PATIENT: (PATIENT NAME) reported that (he/she) received health care services from this facility during 1997. MEDICAL RECORDS 1. The (first/next) time (PATIENT NAME) received services during calendar year 1997, were.
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