Survey Text

2021 2017 2013 2009
2020 2016 2012 2008
2019 2015 2011
2018 2014 2010
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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
PE12
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How old (were/was) (PERSON) when the other kind of heart condition, that is the [OTHER HEART CONDITION SPECIFY TEXT], was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
[Enter Age-3] ......................... [BOX_07]
REF ................................... -7 [BOX_07]
DK .................................... -8 [BOX_07]
----------------------------------------------------
FOR 'OTHER HEART CONDITION SPECIFY TEXT', DISPLAY THE TEXT ENTERED AT PE11OV.
----------------------------------------------------
----------------------------------------------------
HARD CHECK:
RANGE CHECK: 0 TO PERSON'S CURRENT AGE
----------------------------------------------------

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2017
Survey form view entire document:  text  image
PE12
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How old (were/was) (PERSON) when the other kind of heart condition, that is the [OTHER HEART CONDITION SPECIFY TEXT], was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
[Enter Age-3] ......................... [BOX_07]
REF ................................... -7 [BOX_07]
DK .................................... -8 [BOX_07]
----------------------------------------------------
FOR 'OTHER HEART CONDITION SPECIFY TEXT', DISPLAY THE TEXT ENTERED AT PE11OV.
----------------------------------------------------
----------------------------------------------------
HARD CHECK:
RANGE CHECK: 0 TO PERSON'S CURRENT AGE
----------------------------------------------------

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2016
Survey form view entire document:  text  image
PE12
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How old (were/was) (PERSON) when the other kind of heart condition, that is the [OTHER HEART CONDITION SPECIFY TEXT], was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
[Enter Age-3] ......................... [BOX_07]
REF ................................... -7 [BOX_07]
DK .................................... -8 [BOX_07]
----------------------------------------------------
FOR 'OTHER HEART CONDITION SPECIFY TEXT', DISPLAY THE TEXT ENTERED AT PE11OV.
----------------------------------------------------
----------------------------------------------------
HARD CHECK:
RANGE CHECK: 0 TO PERSON'S CURRENT AGE
----------------------------------------------------

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2015
Survey form view entire document:  text  image
PE12
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How old (were/was) (PERSON) when the other kind of heart condition, that is the [OTHER HEART CONDITION SPECIFY TEXT], was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
[Enter Age-3] ......................... [BOX_07]
REF ................................... -7 [BOX_07]
DK .................................... -8 [BOX_07]
----------------------------------------------------
FOR 'OTHER HEART CONDITION SPECIFY TEXT', DISPLAY THE TEXT ENTERED AT PE11OV.
----------------------------------------------------
----------------------------------------------------
HARD CHECK:
RANGE CHECK: 0 TO PERSON'S CURRENT AGE
----------------------------------------------------

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2014
Survey form view entire document:  text  image
PE12
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How old (were/was) (PERSON) when the other kind of heart condition, that is the [OTHER HEART CONDITION SPECIFY TEXT], was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
[Enter Age-3] ......................... [BOX_07]
REF ................................... -7 [BOX_07]
DK .................................... -8 [BOX_07]
----------------------------------------------------
FOR 'OTHER HEART CONDITION SPECIFY TEXT', DISPLAY THE TEXT ENTERED AT PE11OV.
----------------------------------------------------
----------------------------------------------------
HARD CHECK:
RANGE CHECK: 0 TO PERSON'S CURRENT AGE
----------------------------------------------------

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2013
Survey form view entire document:  text  image
PE12
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How old (were/was) (PERSON) when the other kind of heart condition, that is the [OTHER HEART CONDITION SPECIFY TEXT], was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
[Enter Age-3] ......................... [BOX_07]
REF ................................... -7 [BOX_07]
DK .................................... -8 [BOX_07]
----------------------------------------------------
FOR 'OTHER HEART CONDITION SPECIFY TEXT', DISPLAY THE TEXT ENTERED AT PE11OV.
----------------------------------------------------
----------------------------------------------------
HARD CHECK:
RANGE CHECK: 0 TO PERSON'S CURRENT AGE
----------------------------------------------------

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2012
Survey form view entire document:  text  image
PE12
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How old (were/was) (PERSON) when the other kind of heart condition, that is the [OTHER HEART CONDITION SPECIFY TEXT], was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
[Enter Age-3] ......................... [BOX_07]
REF ................................... -7 [BOX_07]
DK .................................... -8 [BOX_07]
----------------------------------------------------
FOR 'OTHER HEART CONDITION SPECIFY TEXT', DISPLAY THE TEXT ENTERED AT PE11OV.
----------------------------------------------------
----------------------------------------------------
HARD CHECK:
RANGE CHECK: 0 TO PERSON'S CURRENT AGE
----------------------------------------------------

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2011
Survey form view entire document:  text  image
PE12
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How old (were/was) (PERSON) when the other kind of heart condition, that is the [OTHER HEART CONDITION SPECIFY TEXT], was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
[Enter Age-3] ......................... [BOX_07]
REF ................................... -7 [BOX_07]
DK .................................... -8 [BOX_07]
----------------------------------------------------
FOR 'OTHER HEART CONDITION SPECIFY TEXT', DISPLAY THE TEXT ENTERED AT PE11OV.
----------------------------------------------------
----------------------------------------------------
HARD CHECK:
RANGE CHECK: 0 TO PERSON'S CURRENT AGE
----------------------------------------------------

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2010
Survey form view entire document:  text  image
PE12
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How old (were/was) (PERSON) when the other kind of heart condition, that is the [OTHER HEART CONDITION SPECIFY TEXT], was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
[Enter Age-3] ......................... [BOX_07]
REF ................................... -7 [BOX_07]
DK .................................... -8 [BOX_07]
----------------------------------------------------
FOR 'OTHER HEART CONDITION SPECIFY TEXT', DISPLAY THE TEXT ENTERED AT PE11OV.
----------------------------------------------------
----------------------------------------------------
HARD CHECK:
RANGE CHECK: 0 TO PERSON'S CURRENT AGE
----------------------------------------------------

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2009
Survey form view entire document:  text  image
PE12
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How old (were/was) (PERSON) when the other kind of heart condition, that is the [OTHER HEART CONDITION SPECIFY TEXT], was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
[Enter Age-3] ......................... [BOX_07]
REF ................................... -7 [BOX_07]
DK .................................... -8 [BOX_07]
----------------------------------------------------
FOR 'OTHER HEART CONDITION SPECIFY TEXT', DISPLAY THE TEXT ENTERED AT PE11OV.
----------------------------------------------------
----------------------------------------------------
HARD CHECK:
RANGE CHECK: 0 TO PERSON'S CURRENT AGE
----------------------------------------------------

top
2008
Survey form view entire document:  text  image
PE12
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How old (were/was) (PERSON) when the other kind of heart condition, that is the [OTHER HEART CONDITION SPECIFY TEXT], was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
[Enter Age-3] ......................... [BOX_07]
REF ................................... -7 [BOX_07]
DK .................................... -8 [BOX_07]
----------------------------------------------------
FOR 'OTHER HEART CONDITION SPECIFY TEXT', DISPLAY THE TEXT ENTERED AT PE11OV.
----------------------------------------------------
----------------------------------------------------
HARD CHECK:
RANGE CHECK: 0 TO PERSON'S CURRENT AGE
----------------------------------------------------