Survey Text

2021 2014 2007 2000
2020 2013 2006 1999
2019 2012 2005 1998
2018 2011 2004 1997
2017 2010 2003 1996
2016 2009 2002
2015 2008 2001
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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
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

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2017
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

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2016
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

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2015
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

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2014
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

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2013
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

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2012
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

top
2011
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

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2010
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

top
2009
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

top
2008
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

top
2007
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

top
2006
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

top
2005
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

top
2004
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

top
2003
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

top
2002
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

top
2001
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

top
2000
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

top
1999
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

top
1998
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

top
1997
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]

top
1996
Survey form view entire document:  text  image
EV06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Thinking about the health care (PERSON) received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid?
Please do not include health care received from friends or relatives living here.
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.
FRIEND/NEIGHBOR ........................ 1 [EV08]
RELATIVE ............................... 2 [EV07]
VOLUNTEER .............................. 3 [EV08]
OTHER-PAID ............................. 4
VOLUNTEERED: MEAL DELIVERY SERVICE .... 5 [BOX_06]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
[Code One]
----------------------------------------------------
DISPLAY 'first' IF NO HH EVENTS ALREADY RECORDED FOR THIS PERSON DURING THE CURRENT ROUND. DISPLAY 'next' IF AT LEAST ONE OTHER HH EVENT RECORDED FOR THIS PERSON DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (VOLUNTEERED: MEAL DELIVERY SERVICE), DO NOT CREATE AN EVENT RECORD.
----------------------------------------------------
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2, QUESTION WAS WORDED, "Thinking about the health care (PERSON) received at home, was the [first/next] type of person who provided home care services to (PERSON) a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please...here." ALSO, IN ROUNDS 1 AND 2, THE SENTENCE "Please...here." WAS NOT IN REVERSE VIDEO.
----------------------------------------------------
EV06A
=====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV] [STR-DT] [END-DT]
Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?
PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?
WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME ........................... 1 [B0X_04]
WORKED FOR SELF ........................ 2 [B0X_04]
REF ................................... -7 [B0X_04]
DK .................................... -8 [B0X_04]
[Code One]