Survey Text

2021 2014 2009 2004
2019 2013 2008 2003
2017 2012 2007 2002
2016 2011 2006 2001
2015 2010 2005 2000
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2021

No questionnaire text is available for this sample.


No questionnaire text is available for this sample.


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2019

No questionnaire text is available for this sample.


No questionnaire text is available for this sample.


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2017
Survey form view entire document:  text  image
11. We want to know your rating of all your health care in the last 12 months from all doctors and other health providers.
Use any number from 0 to 10 where 0 is the worst health care possible, and 10 is the best health care possible.
How would you rate all your health care?
1 Worst health care possible
2
3
4
5
6
7
8
9
10 Best health care possible

Survey form view entire document:  text  image

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2016
Survey form view entire document:  text  image
11. We want to know your rating of all your health care in the last 12 months from all doctors and other health providers.
Use any number from 0 to 10 where 0 is the worst health care possible, and 10 is the best health care possible.
How would you rate all your health care?
1 Worst health care possible
2
3
4
5
6
7
8
9
10 Best health care possible

Survey form view entire document:  text  image

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2015
Survey form view entire document:  text  image
11. We want to know your rating of all your health care in the last 12 months from all doctors and other health providers.
Use any number from 0 to 10 where 0 is the worst health care possible, and 10 is the best health care possible.
How would you rate all your health care?
1 Worst health care possible
2
3
4
5
6
7
8
9
10 Best health care possible

Survey form view entire document:  text  image

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2014
Survey form view entire document:  text  image
11. We want to know your rating of all your health care in the last 12 months from all doctors and other health providers.
Use any number from 0 to 10 where 0 is the worst health care possible, and 10 is the best health care possible.
How would you rate all your health care?
1 Worst health care possible
2
3
4
5
6
7
8
9
10 Best health care possible

Survey form view entire document:  text  image

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2013
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Survey form view entire document:  text  image

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2012
Survey form view entire document:  text  image
11. We want to know your rating of all your health care in the last 12 months from all doctors and other health providers.
Use any number from 0 to 10 where 0 is the worst health care possible, and 10 is the best health care possible. How would you rate all your health care?
0 Worst health care possible ..................
1 ..............................................................
2 ..............................................................
3 ..............................................................
4 ..............................................................
5 ..............................................................
6 ..............................................................
7 ..............................................................
8 ..............................................................
9 ..............................................................
10 Best health care possible ..................
I had no visits in the last 12 months. ......

Survey form view entire document:  text  image

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2011
Survey form view entire document:  text  image
11. We want to know your rating of all your health care in the last 12 months from all doctors and other health providers.
Use any number from 0 to 10 where 0 is the worst health care possible, and 10 is the best health care possible. How would you rate all your health care?
0 Worst health care possible ..................
1 ..............................................................
2 ..............................................................
3 ..............................................................
4 ..............................................................
5 ..............................................................
6 ..............................................................
7 ..............................................................
8 ..............................................................
9 ..............................................................
10 Best health care possible ..................
I had no visits in the last 12 months. ......

Survey form view entire document:  text  image

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2010
Survey form view entire document:  text  image
11. We want to know your rating of all your health care in the last 12 months from all doctors and other health providers.
Use any number from 0 to 10 where 0 is the worst health care possible, and 10 is the best health care possible. How would you rate all your health care?
0 Worst health care possible ..................
1 ..............................................................
2 ..............................................................
3 ..............................................................
4 ..............................................................
5 ..............................................................
6 ..............................................................
7 ..............................................................
8 ..............................................................
9 ..............................................................
10 Best health care possible ..................
I had no visits in the last 12 months. ......

Survey form view entire document:  text  image

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2009
Survey form view entire document:  text  image
11. We want to know your rating of all your health care in the last 12 months from all doctors and other health providers.
Use any number from 0 to 10 where 0 is the worst health care possible, and 10 is the best health care possible.
How would you rate all your health care?
1 Worst health care possible
2
3
4
5
6
7
8
9
10 Best health care possible

Survey form view entire document:  text  image
CS25_02
=======

ENTER OUNCES:
[Enter Ounces] ........................
REF ................................... -7
DK .................................... -8
----------------------------------------------------
SOFT RANGE CHECK: 0-15
----------------------------------------------------
----------------------------------------------------
EDIT: IF POUNDS (CS25_01) = 0, THEN OUNCES MUST BE 1-16.
----------------------------------------------------
----------------------------------------------------
PROGRAMMER NOTE: CS25 WAS PREVIOUSLY NUMBERED HE57.
----------------------------------------------------

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2008
Survey form view entire document:  text  image
11. We want to know your rating of all your health care in the last 12 months from all doctors and other health providers.
Use any number from 0 to 10 where 0 is the worst health care possible, and 10 is the best health care possible. How would you rate all your health care?
0 Worst health care possible ..................
1 ..............................................................
2 ..............................................................
3 ..............................................................
4 ..............................................................
5 ..............................................................
6 ..............................................................
7 ..............................................................
8 ..............................................................
9 ..............................................................
10 Best health care possible ..................
I had no visits in the last 12 months. ......

Survey form view entire document:  text  image
CS25_02
=======

ENTER OUNCES:
[Enter Ounces] ........................
REF ................................... -7
DK .................................... -8
----------------------------------------------------
SOFT RANGE CHECK: 0-15
----------------------------------------------------
----------------------------------------------------
EDIT: IF POUNDS (CS25_01) = 0, THEN OUNCES MUST BE 1-16.
----------------------------------------------------
----------------------------------------------------
PROGRAMMER NOTE: CS25 WAS PREVIOUSLY NUMBERED HE57.
----------------------------------------------------

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2007
Survey form view entire document:  text  image
11. We want to know your rating of all your health care in the last 12 months from all doctors and other health providers.
Use any number from 0 to 10 where 0 is the worst health care possible, and 10 is the best health care possible.
How would you rate all your health care?
1 Worst health care possible
2
3
4
5
6
7
8
9
10 Best health care possible

Survey form view entire document:  text  image

top
2006

No questionnaire text is available for this sample.


Survey form view entire document:  text  image

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2005
Survey form view entire document:  text  image
11. We want to know your rating of all your health care in the last 12 months from all doctors and other health providers.
Use any number from 0 to 10 where 0 is the worst health care possible, and 10 is the best health care possible.
How would you rate all your health care?
1 Worst health care possible
2
3
4
5
6
7
8
9
10 Best health care possible

Survey form view entire document:  text  image

top
2004
Survey form view entire document:  text  image
11. We want to know your rating of all your health care in the last 12 months from all doctors and other health providers.
Use any number from 0 to 10 where 0 is the worst health care possible, and 10 is the best health care possible.
How would you rate all your health care?
1 Worst health care possible
2
3
4
5
6
7
8
9
10 Best health care possible

Survey form view entire document:  text  image

top
2003
Survey form view entire document:  text  image
11. We want to know your rating of all your health care in the last 12 months from all doctors and other health providers.
Use any number from 0 to 10 where 0 is the worst health care possible, and 10 is the best health care possible.
How would you rate all your health care?
1 Worst health care possible
2
3
4
5
6
7
8
9
10 Best health care possible

Survey form view entire document:  text  image

top
2002
Survey form view entire document:  text  image
11. We want to know your rating of all your health care in the last 12 months from all doctors and other health providers.
Use any number from 0 to 10 where 0 is the worst health care possible, and 10 is the best health care possible.
How would you rate all your health care?
1 Worst health care possible
2
3
4
5
6
7
8
9
10 Best health care possible

Survey form view entire document:  text  image
CS19
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
SHOW CARD CS-5.
We want to know your rating of all your child's health care in the last 12 months from all doctors and other health providers.
Use any number from 0 to 10 where 0 is the worst health care possible, and 10 is the best health care possible.
How would you rate all of (PERSON)'s health care?

ENTER RATING FROM 0-10:
[Enter Small Number] ...................
REF ................................... -7
DK .................................... -8
----------------------------------------------------
RANGE CHECK: 0-10
----------------------------------------------------

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2001
Survey form view entire document:  text  image
11. We want to know your rating of all your health care in the last 12 months from all doctors and other health providers.
Use any number from 0 to 10 where 0 is the worst health care possible, and 10 is the best health care possible.
How would you rate all your health care?
1 Worst health care possible
2
3
4
5
6
7
8
9
10 Best health care possible

Survey form view entire document:  text  image
CS19
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
SHOW CARD CS-5.
We want to know your rating of all your child's health care in the last 12 months from all doctors and other health providers.
Use any number from 0 to 10 where 0 is the worst health care possible, and 10 is the best health care possible.
How would you rate all of (PERSON)'s health care?

ENTER RATING FROM 0-10:
[Enter Small Number] ...................
REF ................................... -7
DK .................................... -8
----------------------------------------------------
RANGE CHECK: 0-10
----------------------------------------------------

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2000
Survey form view entire document:  text  image
11. We want to know your rating of all your health care in the last 12 months from all doctors and other health providers.
Use any number from 0 to 10 where 0 is the worst health care possible, and 10 is the best health care possible. How would you rate all your health care?
0 Worst health care possible ..................
1 ..............................................................
2 ..............................................................
3 ..............................................................
4 ..............................................................
5 ..............................................................
6 ..............................................................
7 ..............................................................
8 ..............................................................
9 ..............................................................
10 Best health care possible ..................
I had no visits in the last 12 months. ......

Survey form view entire document:  text  image
11.
We want to know your rating of all your child's health
care in the last 12 months from all doctors and other
health providers.
Use any number from 0 to 10 where 0 is the worst health
care possible, and 10 is the best health care possible. How
would you rate all your child's health care?
0 Worst health care possible ..............
1 ........................................................
2 ........................................................
3 ........................................................
4 ........................................................
5 ........................................................
6 ........................................................
7 ........................................................
8 ........................................................
9 ........................................................
10 Best health care possible ..............
My child had no visits in the last 12 months..............