( ) Never
( ) Sometimes
( ) Usually
( ) Always

4. In the last 12 months, not counting the times you needed care right away, how often did you get an appointment for your health care at a doctor?s office or clinic as soon as you thought you needed?

1 Never
2 Sometimes
3 Usually
4 Always

Disagree Strongly
Disagree Somewhat
Uncertain
Agree Somewhat
Agree Strongly

Disagree Strongly
Disagree Somewhat
Uncertain
Agree Somewhat
Agree Strongly

Disagree Strongly
Disagree Somewhat
Uncertain
Agree Somewhat
Agree Strongly

2. In the last 12 months, how often did you get an appointment for regular or routine health care as soon as you wanted?

Never
Sometimes
Usually
Always

Disagree Strongly
Disagree Somewhat
Uncertain
Agree Somewhat
Agree Strongly

[PERSON'S FIRST MIDDLE AND LAST NAME]
SHOW CARD CS-3.
In the last 12 months, not counting times (PERSON) needed health care right away, how often did (PERSON) get an appointment for health care at a doctor's office or clinic as soon as you thought (he/she) needed?

NEVER .................................. 1 [CS13]
SOMETIMES .............................. 2 [CS13]
USUALLY ................................ 3 [CS13]
ALWAYS ................................. 4 [CS13]
REF ................................... -7 [CS13]
DK .................................... -8 [CS13]
[Code One]
----------------------------------------------------
IN PANEL 12, ROUND 4 AND PANEL 13, ROUND 2, THE QUESTION WORDING AT CS12A WAS UPDATED TO BE MORE CONSISTENT WITH CAHPS VERSION 4.0 QUESTION WORDING.
----------------------------------------------------

5. In the last 12 months (not counting times you went to an emergency room), how many times did you go to a doctor's office or clinic to get care for yourself?

None ..........................................GO TOQUESTION 11
1 ..............................................................
2 ..............................................................
3 ..............................................................
4 ..............................................................
5 to 9 .........................................
10 or more ..................................

[PERSON'S FIRST MIDDLE AND LAST NAME]
SHOW CARD CS-3.
In the last 12 months, not counting times (PERSON) needed health care right away, how often did (PERSON) get an appointment for health care at a doctor's office or clinic as soon as you thought (he/she) needed?

NEVER .................................. 1 [CS13]
SOMETIMES .............................. 2 [CS13]
USUALLY ................................ 3 [CS13]
ALWAYS ................................. 4 [CS13]
REF ................................... -7 [CS13]
DK .................................... -8 [CS13]
[Code One]
----------------------------------------------------
IN PANEL 12, ROUND 4 AND PANEL 13, ROUND 2, THE QUESTION WORDING AT CS12A WAS UPDATED TO BE MORE CONSISTENT WITH CAHPS VERSION 4.0 QUESTION WORDING.
----------------------------------------------------

Disagree Strongly
Disagree Somewhat
Uncertain
Agree Somewhat
Agree Strongly

[PERSON'S FIRST MIDDLE AND LAST NAME]
SHOW CARD CS-3.
In the last 12 months, not counting times (PERSON) needed health care right away, how often did (PERSON) get an appointment for health care at a doctor's office or clinic as soon as you thought (he/she) needed?

NEVER .................................. 1 [CS13]
SOMETIMES .............................. 2 [CS13]
USUALLY ................................ 3 [CS13]
ALWAYS ................................. 4 [CS13]
REF ................................... -7 [CS13]
DK .................................... -8 [CS13]
[Code One]
----------------------------------------------------
IN PANEL 12, ROUND 4 AND PANEL 13, ROUND 2, THE QUESTION WORDING AT CS12A WAS UPDATED TO BE MORE CONSISTENT WITH CAHPS VERSION 4.0 QUESTION WORDING.
----------------------------------------------------

Disagree Strongly
Disagree Somewhat
Uncertain
Agree Somewhat
Agree Strongly

[PERSON'S FIRST MIDDLE AND LAST NAME]
SHOW CARD CS-3.
In the last 12 months, not counting times (PERSON) needed health care right away, how often did (PERSON) get an appointment for health care at a doctor's office or clinic as soon as you thought (he/she) needed?

NEVER .................................. 1 [CS13]
SOMETIMES .............................. 2 [CS13]
USUALLY ................................ 3 [CS13]
ALWAYS ................................. 4 [CS13]
REF ................................... -7 [CS13]
DK .................................... -8 [CS13]
[Code One]
----------------------------------------------------
IN PANEL 12, ROUND 4 AND PANEL 13, ROUND 2, THE QUESTION WORDING AT CS12A WAS UPDATED TO BE MORE CONSISTENT WITH CAHPS VERSION 4.0 QUESTION WORDING.
----------------------------------------------------

Disagree Strongly
Disagree Somewhat
Uncertain
Agree Somewhat
Agree Strongly

Disagree Strongly
Disagree Somewhat
Uncertain
Agree Somewhat
Agree Strongly

Disagree Strongly
Disagree Somewhat
Uncertain
Agree Somewhat
Agree Strongly

Disagree Strongly
Disagree Somewhat
Uncertain
Agree Somewhat
Agree Strongly

4. In the last 12 months, how often did you get an appointment for health care as soon as you wanted?

Never
Sometimes
Usually
Always

[PERSON'S FIRST MIDDLE AND LAST NAME]
SHOW CARD CS-3.
In the last 12 months, how often did (PERSON) get an appointment for health care as soon as you wanted?

NEVER .................................. 1
SOMETIMES .............................. 2
USUALLY ................................ 3
ALWAYS ................................. 4
REF ................................... -7
DK .................................... -8
[Code One]

2. In the last 12 months, how often did you get an appointment for regular or routine health care as soon as you wanted?

Never ......................................................
Sometimes ..............................................
Usually ....................................................
Always.................................................
I didn't need an appointment for regular or routine care in the last 12 months.......

[PERSON'S FIRST MIDDLE AND LAST NAME]
SHOW CARD CS-3.
In the last 12 months, how often did (PERSON) get an appointment for regular or routine health care as soon as you wanted?

NEVER .................................. 1
SOMETIMES .............................. 2
USUALLY ................................ 3
ALWAYS ................................. 4
REF ................................... -7
DK .................................... -8
[Code One]

2. In the last 12 months, how often did you get an appointment for regular or routine health care as soon as you wanted?

Never ......................................................
Sometimes ..............................................
Usually ....................................................
Always.................................................
I didn't need an appointment for regular or routine care in the last 12 months.......

In the last 12 months, how often did your child get an
appointment for regular or routine health care as
soon as you wanted?

Never ..................................................
Sometimes..........................................
Usually................................................
Always ................................................
My child didn't need an appointment for regular or routine care in the last
12 months.........................................