Survey Text

2022 2016 2010 2004
2021 2015 2009 2003
2020 2014 2008 2002
2019 2013 2007 2001
2018 2012 2006 2000
2017 2011 2005
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2022

No questionnaire text is available for this sample.


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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
CS05
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
Is (PERSON) limited or prevented in any way in (his/her) ability to do the things most children of the same age can do?
YES .................................... 1
NO ..................................... 2 [CS06]
REF ................................... -7 [CS06]
DK .................................... -8 [CS06]

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2017
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CS05
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
Is (PERSON) limited or prevented in any way in (his/her) ability to do the things most children of the same age can do?
YES .................................... 1
NO ..................................... 2 [CS06]
REF ................................... -7 [CS06]
DK .................................... -8 [CS06]

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2016
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CS05
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
Is (PERSON) limited or prevented in any way in (his/her) ability to do the things most children of the same age can do?
YES .................................... 1
NO ..................................... 2 [CS06]
REF ................................... -7 [CS06]
DK .................................... -8 [CS06]

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2015
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CS05
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
Is (PERSON) limited or prevented in any way in (his/her) ability to do the things most children of the same age can do?
YES .................................... 1
NO ..................................... 2 [CS06]
REF ................................... -7 [CS06]
DK .................................... -8 [CS06]

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2014
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CS05
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
Is (PERSON) limited or prevented in any way in (his/her) ability to do the things most children of the same age can do?
YES .................................... 1
NO ..................................... 2 [CS06]
REF ................................... -7 [CS06]
DK .................................... -8 [CS06]

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2013
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CS05
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
Is (PERSON) limited or prevented in any way in (his/her) ability to do the things most children of the same age can do?
YES .................................... 1
NO ..................................... 2 [CS06]
REF ................................... -7 [CS06]
DK .................................... -8 [CS06]

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2012
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CS05
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
Is (PERSON) limited or prevented in any way in (his/her) ability to do the things most children of the same age can do?
YES .................................... 1
NO ..................................... 2 [CS06]
REF ................................... -7 [CS06]
DK .................................... -8 [CS06]

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2011
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CS05
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
Is (PERSON) limited or prevented in any way in (his/her) ability to do the things most children of the same age can do?
YES .................................... 1
NO ..................................... 2 [CS06]
REF ................................... -7 [CS06]
DK .................................... -8 [CS06]

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2010
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CS05
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
Is (PERSON) limited or prevented in any way in (his/her) ability to do the things most children of the same age can do?
YES .................................... 1
NO ..................................... 2 [CS06]
REF ................................... -7 [CS06]
DK .................................... -8 [CS06]

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2009
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CS05
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
Is (PERSON) limited or prevented in any way in (his/her) ability to do the things most children of the same age can do?
YES .................................... 1
NO ..................................... 2 [CS06]
REF ................................... -7 [CS06]
DK .................................... -8 [CS06]

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2008
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CS05
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
Is (PERSON) limited or prevented in any way in (his/her) ability to do the things most children of the same age can do?
YES .................................... 1
NO ..................................... 2 [CS06]
REF ................................... -7 [CS06]
DK .................................... -8 [CS06]

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2007
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CS05
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
Is (PERSON) limited or prevented in any way in (his/her) ability to do the things most children of the same age can do?
YES .................................... 1
NO ..................................... 2 [CS06]
REF ................................... -7 [CS06]
DK .................................... -8 [CS06]

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2006
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CS05
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
Is (PERSON) limited or prevented in any way in (his/her) ability to do the things most children of the same age can do?
YES .................................... 1
NO ..................................... 2 [CS06]
REF ................................... -7 [CS06]
DK .................................... -8 [CS06]

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2005
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CS05
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
Is (PERSON) limited or prevented in any way in (his/her) ability to do the things most children of the same age can do?
YES .................................... 1
NO ..................................... 2 [CS06]
REF ................................... -7 [CS06]
DK .................................... -8 [CS06]

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2004
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CS05
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
Is (PERSON) limited or prevented in any way in (his/her) ability to do the things most children of the same age can do?
YES .................................... 1
NO ..................................... 2 [CS06]
REF ................................... -7 [CS06]
DK .................................... -8 [CS06]

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2003
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CS05
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
Is (PERSON) limited or prevented in any way in (his/her) ability to do the things most children of the same age can do?
YES .................................... 1
NO ..................................... 2 [CS06]
REF ................................... -7 [CS06]
DK .................................... -8 [CS06]

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2002
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CS05
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
Is (PERSON) limited or prevented in any way in (his/her) ability to do the things most children of the same age can do?
YES .................................... 1
NO ..................................... 2 [CS06]
REF ................................... -7 [CS06]
DK .................................... -8 [CS06]

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2001
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CS05
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
Is (PERSON) limited or prevented in any way in (his/her) ability to do the things most children of the same age can do?
YES .................................... 1
NO ..................................... 2 [CS06]
REF ................................... -7 [CS06]
DK .................................... -8 [CS06]

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2000
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16.
Is your child limited or prevented in any way in his
or her ability to do the things most children of the
same age can do?
Yes..........................................
No ..........................................GO TO QUESTION 17
A.
Is this because of any medical, behavioral, or other health condition?
Yes..........................................
No .........................................GO TO QUESTION 17
B.
Is this a condition that has lasted or is expected
to last for at least 12 months?
Yes..........................................
No ..........................................