Survey Text

2021 2014 2007 2000
2020 2013 2006 1999
2019 2012 2005 1998
2018 2011 2004 1997
2017 2010 2003 1996
2016 2009 2002
2015 2008 2001
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2021

No questionnaire text is available for this sample.


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2020

No questionnaire text is available for this sample.


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2019

No questionnaire text is available for this sample.


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2018
Survey form view entire document:  text  image
CN01A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
Which of [your/[PERSON]?s] health conditions were due to an accident or injury?
PROBE: Any other health conditions due to an accident or injury?
[1. Medical Condition] .................
[2. Medical Condition] .................
[3. Medical Condition] .................
HELP AVAILABLE FOR DEFINITION OF ACCIDENT/INJURY.
----------------------------------------------------
FLAG ALL CONDITIONS SELECTED AT CN01A AS ?DUE TO ACCIDENT/INJURY?.
----------------------------------------------------
----------------------------------------------------
CONTINUE WITH BOX_05
----------------------------------------------------
----------------------------------------------------
ROSTER DETAILS:
Title: PERS_COND_1
COL #1 HEADER: CONDITION INSTRUCTIONS: DISPLAY NAME OF MEDICAL CONDITION (COND.CONDNAM)
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION:
DISPLAY THE PERSON-MEDICAL-CONDITIONS-ROSTER FOR SELECTION.
----------------------------------------------------
----------------------------------------------------
ROSTER BEHAVIOR:
1. MULTIPLE SELECT ALLOWED.
2. ADD, EDIT, AND DELETE DISALLOWED.
----------------------------------------------------
----------------------------------------------------
ROSTER FILTER:
DISPLAY CONDITIONS THAT MEET THE FOLLOWING:
1. CONDITION IS FLAGGED AS ?CREATED? DURING THE CURRENT ROUND.
2. CONDITION IS NOT A PRIORITY CONDITION, THAT IS, THE CONDITION IS NOT FLAGGED AS CREATED IN THE PE SECTION.
----------------------------------------------------

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2017
Survey form view entire document:  text  image
CN01A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
Which of [your/[PERSON]?s] health conditions were due to an accident or injury?
PROBE: Any other health conditions due to an accident or injury?
[1. Medical Condition] .................
[2. Medical Condition] .................
[3. Medical Condition] .................
HELP AVAILABLE FOR DEFINITION OF ACCIDENT/INJURY.
----------------------------------------------------
FLAG ALL CONDITIONS SELECTED AT CN01A AS ?DUE TO ACCIDENT/INJURY?.
----------------------------------------------------
----------------------------------------------------
CONTINUE WITH BOX_05
----------------------------------------------------
----------------------------------------------------
ROSTER DETAILS:
Title: PERS_COND_1
COL #1 HEADER: CONDITION INSTRUCTIONS: DISPLAY NAME OF MEDICAL CONDITION (COND.CONDNAM)
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION:
DISPLAY THE PERSON-MEDICAL-CONDITIONS-ROSTER FOR SELECTION.
----------------------------------------------------
----------------------------------------------------
ROSTER BEHAVIOR:
1. MULTIPLE SELECT ALLOWED.
2. ADD, EDIT, AND DELETE DISALLOWED.
----------------------------------------------------
----------------------------------------------------
ROSTER FILTER:
DISPLAY CONDITIONS THAT MEET THE FOLLOWING:
1. CONDITION IS FLAGGED AS ?CREATED? DURING THE CURRENT ROUND.
2. CONDITION IS NOT A PRIORITY CONDITION, THAT IS, THE CONDITION IS NOT FLAGGED AS CREATED IN THE PE SECTION.
----------------------------------------------------

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2016
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

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2015
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

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2014
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

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2013
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

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2012
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

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2011
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

top
2010
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

top
2009
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

top
2008
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

top
2007
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

top
2006
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

top
2005
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

top
2004
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

top
2003
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

top
2002
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

top
2001
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

top
2000
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

top
1999
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

top
1998
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

top
1997
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------

top
1996
Survey form view entire document:  text  image
CN02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
[Was the (CONDITION) due to an accident or injury?/INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.]
IF OBVIOUS, CODE WITHOUT ASKING.
TO LEAVE, PRESS ESC.
1 = YES 2 = NO
ROSTER. CONDITION
CN02_02. ACCIDENT/ INJURY?
CN02_03. ON LIST?
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
[PERSON'S CN MEDICAL CONDITION.] ( ) ( )
PRESS F1 FOR DEFINITION OF ACCIDENT/INJURY AND LIST OF PRIORITY CONDITIONS.
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICAL CONDITIONS IN THE PERSON'S-MEDICAL-CONDITIONS- ROSTER THAT MEET THE FOLLOWING CONDITION:

- MEDICAL CONDITION IS FLAGGED AS 'CREATED' FOR PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
CN02 SCREEN BEHAVIOR AND FILL SPECIFICATIONS:

1. DO NOT ALLOW CONDITIONS TO BE ADDED, EDITED, OR DELETED.
2. ESC CANNOT BE USED ON THIS SCREEN UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR. IF ESC IS USED BEFORE ALL FIELDS ARE COMPLETED, DISPLAY THE FOLLOWING MESSAGE: 'CANNOT LEAVE SCREEN UNLESS ALL FIELDS COMPLETED. CHECK FOR BLANK FIELDS. PRESS ENTER TO CONTINUE.'
3. THE CURSOR WILL MOVE FROM CN02_02 TO CN02_03 FOR THE SAME CONDITION AND THEN WILL MOVE TO CN02_02 FOR THE NEXT CONDITION ON THE ROSTER, ETC. THE CURSOR MOVES IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED. IF 'PREGNANCY' IS THE CONDITION, THE CURSOR SKIPS TO THE NEXT CONDITION. IF CONDITION WAS SELECTED AT DN02, THUS CN02_02 IS ALREADY PRECODED, THE CURSOR SKIPS TO CN02_03 FOR THAT CONDITION.
4. WHEN THE CURSOR IS IN COLUMN CN02_02 THE FOLLOWING QUESTION SHOULD BE DISPLAYED: 'Was the (CONDITION) due to an accident or injury?'.
WHEN THE CURSOR IS IN COLUMN CN02_03 THE FOLLOWING TEXT SHOULD BE DISPLAYED:
'INTERVIEWER: CHECK (CONDITION) AGAINST PRIORITY LIST JOB AID.'
----------------------------------------------------
----------------------------------------------------
REFUSED ('-7') AND DON'T KNOW ('-8') DISALLOWED AT BOTH CN02_02 AND CN02_03.
----------------------------------------------------
----------------------------------------------------
NOTE: CAPI WILL PRECODE PREGNANCY AS '2' (NO) IN BOTH CN02_02 AND CN02_03. THESE PRECODED RESPONSES WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.

CAPI WILL ALSO PRECODE ALL CONDITIONS SELECTED AT DN02 AS '1' (YES) IN CN02_02. THIS PRECODED RESPONSE WILL ALREADY APPEAR AT CN02 BEFORE THE INTERVIEWER ENTERS ANY RESPONSES.
----------------------------------------------------
----------------------------------------------------
FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_02 AS 'DUE TO ACCIDENT/INJURY'. FLAG ALL CONDITIONS CODED '1' (YES) AT CN02_03 AS 'ON PRIORITY LIST'.
----------------------------------------------------