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National Center for Health Statistics 3311 Toledo Road Hyattsville, Maryland 20782
Toll Free Data Inquiries 1-800-232-4636


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N H A M C S logoAmbulatory Health Care Data
NAMCS/NHAMCS Home | NAMCS Participants
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For more information, contact the Ambulatory and Hospital Care Statistics Branch at
(301) 458-4600.

Survey Instrument
NAMCS

2008

bullet graphicPatient Record Form Click to open pdf. file  246 KB

bullet graphicCervical Cancer Screening Supplement Click to open pdf. file  406 KB

bullet graphicPhysician Induction Interview Form Click to open pdf. file 1869 KB

bullet graphicCommunity Health Center Induction Interview Form Click to open pdf. file 703 KB

bullet graphicElectronic Medical Records Supplement Click to open pdf. file 346 KB

2007

bullet graphicPatient Record Form Click to open pdf. file   94 KB

bullet graphicCervical Cancer Screening Supplement Click to open pdf. file  70 KB

bullet graphicPhysician Induction Interview Form Click to open pdf. file  400 KB

bullet graphicCommunity Health Center Induction Interview Form Click to open pdf. file 218 KB

2006

bullet graphicPatient Record Form Click to open pdf file 104 KB

bullet graphicCervical Cancer Screening Supplement Click to open pdf file 259 KB

bullet graphicPhysician Induction Interview Form Click to open pdf file 829 KB

bullet graphicCommunity Health Center Induction Interview Form Click to open pdf file 435 KB

2005

bullet graphicPatient Record Form Click to open pdf file 58 KB

bullet graphicPhysician Induction Interview Form Click to open pdf file 123 KB

2004

bullet graphicPatient Record Form Click to open pdf file 141 KB

2003

bullet graphicPatient Record Form Click to open pdf file 142 KB

2002

bullet graphicPatient Record Form Click to open pdf file 747 KB

2001

bullet graphicPatient Record Form (Version A) Click to open pdf file 299 KB

1999-2000

bullet graphicPatient Record Form Click to open pdf file 1.7 KB

1997-1998

bullet graphicPatient Record Form Click to open pdf file 237 KB

bullet graphicInstructions for completing Patient Record Form Click to open pdf file 38 KB

1995-1996

bullet graphicPatient Record Form Click to open pdf file 63 KB

Survey Instrument
NHAMCS

2008

bullet graphicEmergency Department Patient Record Form Click to open pdf. file 208 KB

bullet graphicOutpatient Department Patient Record Form Click to open pdf. file  453 KB

bullet graphicCervical Cancer Screening Supplement Click to open pdf file 189 KB

bullet graphicHospital Induction Interview Form Click to open pdf. file 1277 KB

bullet graphicAmbulatory Unit Induction Interview Form Click to open pdf. file 129 KB

bullet graphicPandemic and Emergency Response Preparedness Supplement Click to open pdf. file 114 KB

2007

bullet graphicEmergency Department Patient Record Form Click to open pdf. file 439 KB

bullet graphicOutpatient Department Patient Record Form Click to open pdf. file  146 KB

bullet graphicCervical Cancer Screening Supplement Click to open pdf file 62 KB

bullet graphicHospital Induction Interview Form Click to open pdf. file 132 KB

bullet graphicAmbulatory Unit Induction Interview Form Click to open pdf. file 120 KB

2006

bullet graphicEmergency Department Patient Record Form Click to open pdf 66 KB

bullet graphicOutpatient Department Patient Record Form Click to open pdf file 58 KB

bullet graphicEmergency Pediatric Surveillance and Equipment Supplement
Click to open pdf file 54 KB

bullet graphicCervical Cancer Screening Supplement Click to open pdf file 54 KB

bullet graphicHospital Induction Interview Form Click to open pdf file 126 KB

bullet graphicAmbulatory Unit Induction Interview Form Click to open pdf file 54 KB

2005

bullet graphicEmergency Department Patient Record Form Click to open pdf file 66 KB

bullet graphicOutpatient Department Patient Record Form Click to open pdf file 58 KB

bullet graphicHospital Induction Interview Form Click to open pdf file 126 KB

bullet graphicAmbulatory Unit Induction Interview Form Click to open pdf file 54 KB

2004

bullet graphicEmergency Department Patient Record Form Click to open pdf file 158 KB

bullet graphicOutpatient Department Patient Record Form Click to open pdf file 361 KB

2003

bullet graphicEmergency Department Patient Record Form Click to open pdf file 383 KB

bullet graphicOutpatient Department Patient Record Form Click to open pdf file 312 KB

2002

bullet graphicEmergency Department Patient Record Form Click to open pdf file 1.5 MB

bullet graphicOutpatient Department Patient Record Form Click to open pdf file 1 MB

2001

bullet graphicEmergency Department Patient Record Form Click to open pdf file 259 KB

bullet graphicOutpatient Department Patient Record Form (Version A) Click to open pdf file 319 KB

1999-2000

bullet graphicEmergency Department Patient Record Form Click to open pdf file 2.1 KB

bullet graphicOutpatient Department Patient Record Form Click to open pdf file 1.7 KB

1997-1998

bullet graphicEmergency Department Patient Record Form Click to open pdf file 205 KB

bullet graphicOutpatient Department Patient Record Form Click to open pdf file 208 KB

bullet graphicInstructions for completing Patient Record Form Click to open pdf file 51 KB

1995-1996

bullet graphicEmergency Department Patient Record Form Click to open pdf file 74 KB

bullet graphicOutpatient Department Patient Record Form Click to open pdf file 73 KB

 

NAMCS/NHAMCS Home | NAMCS Participants
NHAMCS Participants | What's New | Coming Soon
NAMCS Description | NHAMCS Description | Data Highlights
Survey Methodology | Publications | Micro-data | Drug Database
Confidentiality | FAQ's | Links to Related Sites
CDC/NCHS Privacy Policy Notice
| Accessibility | Search NCHS
NCHS Home | Contact us
For more information, contact the Ambulatory and Hospital Care Statistics Branch at
(301) 458-4600.

 

NCHS Home | NHCS Home | NAMCS/NHAMCS | NHHCS | NNHS
NHDS/NSAS | NEHIS | CDC/NCHS Privacy Policy Notice
Accessibility | Search NCHS |
Contact us


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This page last reviewed October 15, 2008

H H S Health and Human Services logo and link
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
National Center for Health Statistics
Hyattsville, MD
20782

1-800-232-4636