[PERSON'S FIRST MIDDLE AND LAST NAME]
In the last 12 months, not counting the times (PERSON) needed health care right away, did you make any appointments for (PERSON)'s health care at a doctor's office or clinic?

YES .................................... 1 [CS12A]
NO ..................................... 2 [CS13]
REF ................................... -7 [CS13]
DK .................................... -8 [CS13]
----------------------------------------------------
IN PANEL 12, ROUND 4 AND PANEL 13, ROUND 2, THE QUESTION WORDING AT CS11A WAS UPDATED TO BE MORE CONSISTENT WITH CAHPS VERSION 4.0 QUESTION WORDING.
----------------------------------------------------

[PERSON'S FIRST MIDDLE AND LAST NAME]
In the last 12 months, not counting the times (PERSON) needed health care right away, did you make any appointments for (PERSON)'s health care at a doctor's office or clinic?

YES .................................... 1 [CS12A]
NO ..................................... 2 [CS13]
REF ................................... -7 [CS13]
DK .................................... -8 [CS13]
----------------------------------------------------
IN PANEL 12, ROUND 4 AND PANEL 13, ROUND 2, THE QUESTION WORDING AT CS11A WAS UPDATED TO BE MORE CONSISTENT WITH CAHPS VERSION 4.0 QUESTION WORDING.
----------------------------------------------------

[PERSON'S FIRST MIDDLE AND LAST NAME]
In the last 12 months, not counting the times (PERSON) needed health care right away, did you make any appointments for (PERSON)'s health care at a doctor's office or clinic?

YES .................................... 1 [CS12A]
NO ..................................... 2 [CS13]
REF ................................... -7 [CS13]
DK .................................... -8 [CS13]
----------------------------------------------------
IN PANEL 12, ROUND 4 AND PANEL 13, ROUND 2, THE QUESTION WORDING AT CS11A WAS UPDATED TO BE MORE CONSISTENT WITH CAHPS VERSION 4.0 QUESTION WORDING.
----------------------------------------------------

[PERSON'S FIRST MIDDLE AND LAST NAME]
In the last 12 months, not counting the times (PERSON) needed health care right away, did you make any appointments for (PERSON)'s health care at a doctor's office or clinic?

YES .................................... 1 [CS12A]
NO ..................................... 2 [CS13]
REF ................................... -7 [CS13]
DK .................................... -8 [CS13]
----------------------------------------------------
IN PANEL 12, ROUND 4 AND PANEL 13, ROUND 2, THE QUESTION WORDING AT CS11A WAS UPDATED TO BE MORE CONSISTENT WITH CAHPS VERSION 4.0 QUESTION WORDING.
----------------------------------------------------

[PERSON'S FIRST MIDDLE AND LAST NAME]
In the last 12 months, not counting the times (PERSON) needed health care right away, did you make any appointments for (PERSON)'s health care at a doctor's office or clinic?

YES .................................... 1 [CS12A]
NO ..................................... 2 [CS13]
REF ................................... -7 [CS13]
DK .................................... -8 [CS13]
----------------------------------------------------
IN PANEL 12, ROUND 4 AND PANEL 13, ROUND 2, THE QUESTION WORDING AT CS11A WAS UPDATED TO BE MORE CONSISTENT WITH CAHPS VERSION 4.0 QUESTION WORDING.
----------------------------------------------------

1. A health provider could be a general doctor, a specialist doctor, a nurse practitioner, a physician assistant, a nurse, or anyone else you would see for healthcare.
In the last 12 months, did you make any appointments with a doctor or other health provider for regular or routine health care?

Yes
No, Skip to Question 3

[PERSON'S FIRST MIDDLE AND LAST NAME]
In the last 12 months, not counting the times (PERSON) needed health care right away, did you make any appointments for (PERSON)'s health care at a doctor's office or clinic?

YES .................................... 1 [CS12A]
NO ..................................... 2 [CS13]
REF ................................... -7 [CS13]
DK .................................... -8 [CS13]
----------------------------------------------------
IN PANEL 12, ROUND 4 AND PANEL 13, ROUND 2, THE QUESTION WORDING AT CS11A WAS UPDATED TO BE MORE CONSISTENT WITH CAHPS VERSION 4.0 QUESTION WORDING.
----------------------------------------------------

[PERSON'S FIRST MIDDLE AND LAST NAME]
In the last 12 months, not counting the times (PERSON) needed health care right away, did you make any appointments for (PERSON)'s health care at a doctor's office or clinic?

YES .................................... 1 [CS12A]
NO ..................................... 2 [CS13]
REF ................................... -7 [CS13]
DK .................................... -8 [CS13]
----------------------------------------------------
IN PANEL 12, ROUND 4 AND PANEL 13, ROUND 2, THE QUESTION WORDING AT CS11A WAS UPDATED TO BE MORE CONSISTENT WITH CAHPS VERSION 4.0 QUESTION WORDING.
----------------------------------------------------

4. In the last 12 months, when you needed care right away for an illness or injury, how often did you get care as soon as you wanted?

Never ......................................................
Sometimes ..............................................
Usually ....................................................
Always..............................................
I didn't need care right away for an illness or injury in the last 12 months.....

[PERSON'S FIRST MIDDLE AND LAST NAME]
In the last 12 months, not counting the times (PERSON) needed health care right away, did you make any appointments for (PERSON)'s health care at a doctor's office or clinic?

YES .................................... 1 [CS12A]
NO ..................................... 2 [CS13]
REF ................................... -7 [CS13]
DK .................................... -8 [CS13]
----------------------------------------------------
IN PANEL 12, ROUND 4 AND PANEL 13, ROUND 2, THE QUESTION WORDING AT CS11A WAS UPDATED TO BE MORE CONSISTENT WITH CAHPS VERSION 4.0 QUESTION WORDING.
----------------------------------------------------

[PERSON'S FIRST MIDDLE AND LAST NAME]
In the last 12 months, not counting the times (PERSON) needed health care right away, did you make any appointments for (PERSON)'s health care at a doctor's office or clinic?

YES .................................... 1 [CS12A]
NO ..................................... 2 [CS13]
REF ................................... -7 [CS13]
DK .................................... -8 [CS13]
----------------------------------------------------
IN PANEL 12, ROUND 4 AND PANEL 13, ROUND 2, THE QUESTION WORDING AT CS11A WAS UPDATED TO BE MORE CONSISTENT WITH CAHPS VERSION 4.0 QUESTION WORDING.
----------------------------------------------------

[PERSON'S FIRST MIDDLE AND LAST NAME]
In the last 12 months, not counting the times (PERSON) needed health care right away, did you make any appointments for (PERSON)'s health care at a doctor's office or clinic?

YES .................................... 1 [CS12A]
NO ..................................... 2 [CS13]
REF ................................... -7 [CS13]
DK .................................... -8 [CS13]
----------------------------------------------------
IN PANEL 12, ROUND 4 AND PANEL 13, ROUND 2, THE QUESTION WORDING AT CS11A WAS UPDATED TO BE MORE CONSISTENT WITH CAHPS VERSION 4.0 QUESTION WORDING.
----------------------------------------------------

[PERSON'S FIRST MIDDLE AND LAST NAME]
The following questions are about the health care (PERSON) received in the last 12 months. A health provider could be a general doctor, a specialist doctor, a nurse practitioner, a physician assistant, a nurse, or anyone else (PERSON) would see for health care.
In the last 12 months, did you make any appointments for (PERSON) with a doctor or other health provider for regular or routine health care?

YES .................................... 1
NO ..................................... 2 [CS11]
REF ................................... -7 [CS11]
DK .................................... -8 [CS11]

[PERSON'S FIRST MIDDLE AND LAST NAME]
The following questions are about the health care (PERSON) received in the last 12 months. A health provider could be a general doctor, a specialist doctor, a nurse practitioner, a physician assistant, a nurse, or anyone else (PERSON) would see for health care.
In the last 12 months, did you make any appointments for (PERSON) with a doctor or other health provider for regular or routine health care?

YES .................................... 1
NO ..................................... 2 [CS11]
REF ................................... -7 [CS11]
DK .................................... -8 [CS11]

[PERSON'S FIRST MIDDLE AND LAST NAME]
The following questions are about the health care (PERSON) received in the last 12 months. A health provider could be a general doctor, a specialist doctor, a nurse practitioner, a physician assistant, a nurse, or anyone else (PERSON) would see for health care.
In the last 12 months, did you make any appointments for (PERSON) with a doctor or other health provider for regular or routine health care?

YES .................................... 1
NO ..................................... 2 [CS11]
REF ................................... -7 [CS11]
DK .................................... -8 [CS11]

[PERSON'S FIRST MIDDLE AND LAST NAME]
The following questions are about the health care (PERSON) received in the last 12 months. A health provider could be a general doctor, a specialist doctor, a nurse practitioner, a physician assistant, a nurse, or anyone else (PERSON) would see for health care.
In the last 12 months, did you make any appointments for (PERSON) with a doctor or other health provider for regular or routine health care?

YES .................................... 1
NO ..................................... 2 [CS11]
REF ................................... -7 [CS11]
DK .................................... -8 [CS11]

[PERSON'S FIRST MIDDLE AND LAST NAME]
The following questions are about the health care (PERSON) received in the last 12 months. A health provider could be a general doctor, a specialist doctor, a nurse practitioner, a physician assistant, a nurse, or anyone else (PERSON) would see for health care.
In the last 12 months, did you make any appointments for (PERSON) with a doctor or other health provider for regular or routine health care?

YES .................................... 1
NO ..................................... 2 [CS11]
REF ................................... -7 [CS11]
DK .................................... -8 [CS11]

3. A health provider could be a general doctor, a specialist doctor, a nurse practitioner, a physician assistant, a nurse, or anyone else you would see for health care.
In the last 12 months, not counting the times you needed health care right away, did you make any appointments with a doctor or other health provider for health care?

Yes
No, Skip to Question 5

[PERSON'S FIRST MIDDLE AND LAST NAME]
The following questions are about the health care (PERSON) received in the last 12 months. A health provider could be a general doctor, a specialist doctor, a nurse practitioner, a physician assistant, a nurse, or anyone else (PERSON) would see for health care.
In the last 12 months, did you make any appointments for (PERSON) with a doctor or other health provider for regular or routine health care?

YES .................................... 1
NO ..................................... 2 [CS11]
REF ................................... -7 [CS11]
DK .................................... -8 [CS11]

1. A health provider could be a general doctor, a specialist doctor, a nurse practitioner, a physician assistant, a nurse, or anyone else you would see for health care. In the last 12 months, did you make any appointments with a doctor or other health provider for regular or routine health care?

Yes .................................
No ..................................GO TO QUESTION 3

[PERSON'S FIRST MIDDLE AND LAST NAME]
The following questions are about the health care (PERSON) received in the last 12 months. A health provider could be a general doctor, a specialist doctor, a nurse practitioner, a physician assistant, a nurse, or anyone else (PERSON) would see for health care.
In the last 12 months, did you make any appointments for (PERSON) with a doctor or other health provider for regular or routine health care?

YES .................................... 1
NO ..................................... 2 [CS11]
REF ................................... -7 [CS11]
DK .................................... -8 [CS11]

1. A health provider could be a general doctor, a specialist doctor, a nurse practitioner, a physician assistant, a nurse, or anyone else you would see for health care. In the last 12 months, did you make any appointments with a doctor or other health provider for regular or routine health care?

Yes .................................
No ..................................GO TO QUESTION 3

A health provider could be a general doctor, a specialist
doctor, a nurse practitioner, a physician assistant, a
nurse, or anyone else your child would see for health
care.
In the last 12 months, did you make any appointments
for your child with a doctor or other health
provider for regular or routine health care?

Yes..........................................
No .........................................GO TO QUESTION 3