Survey Text

2017 2014 2011 2005
2016 2013 2008 2002
2015 2012 2007
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2017
Survey form view entire document:  text  image
AC04
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
What are the other reasons (PERSON) (do/does) not have a usual source of health care?
CODE ALL THAT APPLY.
NO OTHER REASONS ........................ 0
SELDOM OR NEVER GETS SICK ............... 1
RECENTLY MOVED INTO AREA ................ 2
DON'T KNOW WHERE TO GO FOR CARE ......... 3
USUAL SOURCE OF MEDICAL CARE IN THIS AREA IS NO LONGER AVAILABLE ........... 4
CAN'T FIND A PROVIDER WHO SPEAKS (PERSON)'S LANGUAGE ................... 5
LIKES TO GO TO DIFFERENT PLACES FOR DIFFERENT HEALTH NEEDS ................ 6
JUST CHANGED INSURANCE PLANS ............ 7
DON'T USE DOCTORS/TREAT MYSELF .......... 8
COST OF MEDICAL CARE .................... 9
OTHER REASON ............................ 91
REF ..................................... -7
DK ...................................... -8
[Code All That Apply]
PRESS F1 FOR DEFINITION OF USUAL SOURCE OF HEALTH CARE.
----------------------------------------------------
IF CODED '91' (OTHER REASON) ALONE OR IN COMBINATION WITH OTHER CODES, CONTINUE WITH AC04OV
----------------------------------------------------
----------------------------------------------------
OTHERWISE, GO TO END_LP01
----------------------------------------------------
----------------------------------------------------
EDIT: IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8 (DON'T KNOW) IN THE FIRST FIELD, NO OTHER REASON CATEGORY CAN BE CODED. IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8' (DON'T KNOW), IN A FIELD OTHER THAN THE FIRST FIELD AND A SUBSEQUENT CODE IS ENTERED, DISPLAY THE FOLLOWING MESSAGE: 'INVALID RESPONSE. PRESS ENTER ON A BLANK FIELD.'
----------------------------------------------------

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2016
Survey form view entire document:  text  image
AC04
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
What are the other reasons (PERSON) (do/does) not have a usual source of health care?
CODE ALL THAT APPLY.
NO OTHER REASONS ........................ 0
SELDOM OR NEVER GETS SICK ............... 1
RECENTLY MOVED INTO AREA ................ 2
DON'T KNOW WHERE TO GO FOR CARE ......... 3
USUAL SOURCE OF MEDICAL CARE IN THIS AREA IS NO LONGER AVAILABLE ........... 4
CAN'T FIND A PROVIDER WHO SPEAKS (PERSON)'S LANGUAGE ................... 5
LIKES TO GO TO DIFFERENT PLACES FOR DIFFERENT HEALTH NEEDS ................ 6
JUST CHANGED INSURANCE PLANS ............ 7
DON'T USE DOCTORS/TREAT MYSELF .......... 8
COST OF MEDICAL CARE .................... 9
OTHER REASON ............................ 91
REF ..................................... -7
DK ...................................... -8
[Code All That Apply]
PRESS F1 FOR DEFINITION OF USUAL SOURCE OF HEALTH CARE.
----------------------------------------------------
IF CODED '91' (OTHER REASON) ALONE OR IN COMBINATION WITH OTHER CODES, CONTINUE WITH AC04OV
----------------------------------------------------
----------------------------------------------------
OTHERWISE, GO TO END_LP01
----------------------------------------------------
----------------------------------------------------
EDIT: IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8 (DON'T KNOW) IN THE FIRST FIELD, NO OTHER REASON CATEGORY CAN BE CODED. IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8' (DON'T KNOW), IN A FIELD OTHER THAN THE FIRST FIELD AND A SUBSEQUENT CODE IS ENTERED, DISPLAY THE FOLLOWING MESSAGE: 'INVALID RESPONSE. PRESS ENTER ON A BLANK FIELD.'
----------------------------------------------------

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2015
Survey form view entire document:  text  image
AC04
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
What are the other reasons (PERSON) (do/does) not have a usual source of health care?
CODE ALL THAT APPLY.
NO OTHER REASONS ........................ 0
SELDOM OR NEVER GETS SICK ............... 1
RECENTLY MOVED INTO AREA ................ 2
DON'T KNOW WHERE TO GO FOR CARE ......... 3
USUAL SOURCE OF MEDICAL CARE IN THIS AREA IS NO LONGER AVAILABLE ........... 4
CAN'T FIND A PROVIDER WHO SPEAKS (PERSON)'S LANGUAGE ................... 5
LIKES TO GO TO DIFFERENT PLACES FOR DIFFERENT HEALTH NEEDS ................ 6
JUST CHANGED INSURANCE PLANS ............ 7
DON'T USE DOCTORS/TREAT MYSELF .......... 8
COST OF MEDICAL CARE .................... 9
OTHER REASON ............................ 91
REF ..................................... -7
DK ...................................... -8
[Code All That Apply]
PRESS F1 FOR DEFINITION OF USUAL SOURCE OF HEALTH CARE.
----------------------------------------------------
IF CODED '91' (OTHER REASON) ALONE OR IN COMBINATION WITH OTHER CODES, CONTINUE WITH AC04OV
----------------------------------------------------
----------------------------------------------------
OTHERWISE, GO TO END_LP01
----------------------------------------------------
----------------------------------------------------
EDIT: IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8 (DON'T KNOW) IN THE FIRST FIELD, NO OTHER REASON CATEGORY CAN BE CODED. IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8' (DON'T KNOW), IN A FIELD OTHER THAN THE FIRST FIELD AND A SUBSEQUENT CODE IS ENTERED, DISPLAY THE FOLLOWING MESSAGE: 'INVALID RESPONSE. PRESS ENTER ON A BLANK FIELD.'
----------------------------------------------------

top
2014
Survey form view entire document:  text  image
AC04
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
What are the other reasons (PERSON) (do/does) not have a usual source of health care?
CODE ALL THAT APPLY.
NO OTHER REASONS ........................ 0
SELDOM OR NEVER GETS SICK ............... 1
RECENTLY MOVED INTO AREA ................ 2
DON'T KNOW WHERE TO GO FOR CARE ......... 3
USUAL SOURCE OF MEDICAL CARE IN THIS AREA IS NO LONGER AVAILABLE ........... 4
CAN'T FIND A PROVIDER WHO SPEAKS (PERSON)'S LANGUAGE ................... 5
LIKES TO GO TO DIFFERENT PLACES FOR DIFFERENT HEALTH NEEDS ................ 6
JUST CHANGED INSURANCE PLANS ............ 7
DON'T USE DOCTORS/TREAT MYSELF .......... 8
COST OF MEDICAL CARE .................... 9
OTHER REASON ............................ 91
REF ..................................... -7
DK ...................................... -8
[Code All That Apply]
PRESS F1 FOR DEFINITION OF USUAL SOURCE OF HEALTH CARE.
----------------------------------------------------
IF CODED '91' (OTHER REASON) ALONE OR IN COMBINATION WITH OTHER CODES, CONTINUE WITH AC04OV
----------------------------------------------------
----------------------------------------------------
OTHERWISE, GO TO END_LP01
----------------------------------------------------
----------------------------------------------------
EDIT: IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8 (DON'T KNOW) IN THE FIRST FIELD, NO OTHER REASON CATEGORY CAN BE CODED. IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8' (DON'T KNOW), IN A FIELD OTHER THAN THE FIRST FIELD AND A SUBSEQUENT CODE IS ENTERED, DISPLAY THE FOLLOWING MESSAGE: 'INVALID RESPONSE. PRESS ENTER ON A BLANK FIELD.'
----------------------------------------------------

top
2013
Survey form view entire document:  text  image
AC04
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
What are the other reasons (PERSON) (do/does) not have a usual source of health care?
CODE ALL THAT APPLY.
NO OTHER REASONS ........................ 0
SELDOM OR NEVER GETS SICK ............... 1
RECENTLY MOVED INTO AREA ................ 2
DON'T KNOW WHERE TO GO FOR CARE ......... 3
USUAL SOURCE OF MEDICAL CARE IN THIS AREA IS NO LONGER AVAILABLE ........... 4
CAN'T FIND A PROVIDER WHO SPEAKS (PERSON)'S LANGUAGE ................... 5
LIKES TO GO TO DIFFERENT PLACES FOR DIFFERENT HEALTH NEEDS ................ 6
JUST CHANGED INSURANCE PLANS ............ 7
DON'T USE DOCTORS/TREAT MYSELF .......... 8
COST OF MEDICAL CARE .................... 9
OTHER REASON ............................ 91
REF ..................................... -7
DK ...................................... -8
[Code All That Apply]
PRESS F1 FOR DEFINITION OF USUAL SOURCE OF HEALTH CARE.
----------------------------------------------------
IF CODED '91' (OTHER REASON) ALONE OR IN COMBINATION WITH OTHER CODES, CONTINUE WITH AC04OV
----------------------------------------------------
----------------------------------------------------
OTHERWISE, GO TO END_LP01
----------------------------------------------------
----------------------------------------------------
EDIT: IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8 (DON'T KNOW) IN THE FIRST FIELD, NO OTHER REASON CATEGORY CAN BE CODED. IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8' (DON'T KNOW), IN A FIELD OTHER THAN THE FIRST FIELD AND A SUBSEQUENT CODE IS ENTERED, DISPLAY THE FOLLOWING MESSAGE: 'INVALID RESPONSE. PRESS ENTER ON A BLANK FIELD.'
----------------------------------------------------

top
2012
Survey form view entire document:  text  image
AC04
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
What are the other reasons (PERSON) (do/does) not have a usual source of health care?
CODE ALL THAT APPLY.
NO OTHER REASONS ........................ 0
SELDOM OR NEVER GETS SICK ............... 1
RECENTLY MOVED INTO AREA ................ 2
DON'T KNOW WHERE TO GO FOR CARE ......... 3
USUAL SOURCE OF MEDICAL CARE IN THIS AREA IS NO LONGER AVAILABLE ........... 4
CAN'T FIND A PROVIDER WHO SPEAKS (PERSON)'S LANGUAGE ................... 5
LIKES TO GO TO DIFFERENT PLACES FOR DIFFERENT HEALTH NEEDS ................ 6
JUST CHANGED INSURANCE PLANS ............ 7
DON'T USE DOCTORS/TREAT MYSELF .......... 8
COST OF MEDICAL CARE .................... 9
OTHER REASON ............................ 91
REF ..................................... -7
DK ...................................... -8
[Code All That Apply]
PRESS F1 FOR DEFINITION OF USUAL SOURCE OF HEALTH CARE.
----------------------------------------------------
IF CODED '91' (OTHER REASON) ALONE OR IN COMBINATION WITH OTHER CODES, CONTINUE WITH AC04OV
----------------------------------------------------
----------------------------------------------------
OTHERWISE, GO TO END_LP01
----------------------------------------------------
----------------------------------------------------
EDIT: IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8 (DON'T KNOW) IN THE FIRST FIELD, NO OTHER REASON CATEGORY CAN BE CODED. IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8' (DON'T KNOW), IN A FIELD OTHER THAN THE FIRST FIELD AND A SUBSEQUENT CODE IS ENTERED, DISPLAY THE FOLLOWING MESSAGE: 'INVALID RESPONSE. PRESS ENTER ON A BLANK FIELD.'
----------------------------------------------------

top
2011
Survey form view entire document:  text  image
AC04
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
What are the other reasons (PERSON) (do/does) not have a usual source of health care?
CODE ALL THAT APPLY.
NO OTHER REASONS ........................ 0
SELDOM OR NEVER GETS SICK ............... 1
RECENTLY MOVED INTO AREA ................ 2
DON'T KNOW WHERE TO GO FOR CARE ......... 3
USUAL SOURCE OF MEDICAL CARE IN THIS AREA IS NO LONGER AVAILABLE ........... 4
CAN'T FIND A PROVIDER WHO SPEAKS (PERSON)'S LANGUAGE ................... 5
LIKES TO GO TO DIFFERENT PLACES FOR DIFFERENT HEALTH NEEDS ................ 6
JUST CHANGED INSURANCE PLANS ............ 7
DON'T USE DOCTORS/TREAT MYSELF .......... 8
COST OF MEDICAL CARE .................... 9
OTHER REASON ............................ 91
REF ..................................... -7
DK ...................................... -8
[Code All That Apply]
PRESS F1 FOR DEFINITION OF USUAL SOURCE OF HEALTH CARE.
----------------------------------------------------
IF CODED '91' (OTHER REASON) ALONE OR IN COMBINATION WITH OTHER CODES, CONTINUE WITH AC04OV
----------------------------------------------------
----------------------------------------------------
OTHERWISE, GO TO END_LP01
----------------------------------------------------
----------------------------------------------------
EDIT: IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8 (DON'T KNOW) IN THE FIRST FIELD, NO OTHER REASON CATEGORY CAN BE CODED. IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8' (DON'T KNOW), IN A FIELD OTHER THAN THE FIRST FIELD AND A SUBSEQUENT CODE IS ENTERED, DISPLAY THE FOLLOWING MESSAGE: 'INVALID RESPONSE. PRESS ENTER ON A BLANK FIELD.'
----------------------------------------------------

top
2008
Survey form view entire document:  text  image
AC04
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
What are the other reasons (PERSON) (do/does) not have a usual source of health care?
CODE ALL THAT APPLY.
NO OTHER REASONS ........................ 0
SELDOM OR NEVER GETS SICK ............... 1
RECENTLY MOVED INTO AREA ................ 2
DON'T KNOW WHERE TO GO FOR CARE ......... 3
USUAL SOURCE OF MEDICAL CARE IN THIS AREA IS NO LONGER AVAILABLE ........... 4
CAN'T FIND A PROVIDER WHO SPEAKS (PERSON)'S LANGUAGE ................... 5
LIKES TO GO TO DIFFERENT PLACES FOR DIFFERENT HEALTH NEEDS ................ 6
JUST CHANGED INSURANCE PLANS ............ 7
DON'T USE DOCTORS/TREAT MYSELF .......... 8
COST OF MEDICAL CARE .................... 9
OTHER REASON ............................ 91
REF ..................................... -7
DK ...................................... -8
[Code All That Apply]
PRESS F1 FOR DEFINITION OF USUAL SOURCE OF HEALTH CARE.
----------------------------------------------------
IF CODED '91' (OTHER REASON) ALONE OR IN COMBINATION WITH OTHER CODES, CONTINUE WITH AC04OV
----------------------------------------------------
----------------------------------------------------
OTHERWISE, GO TO END_LP01
----------------------------------------------------
----------------------------------------------------
EDIT: IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8 (DON'T KNOW) IN THE FIRST FIELD, NO OTHER REASON CATEGORY CAN BE CODED. IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8' (DON'T KNOW), IN A FIELD OTHER THAN THE FIRST FIELD AND A SUBSEQUENT CODE IS ENTERED, DISPLAY THE FOLLOWING MESSAGE: 'INVALID RESPONSE. PRESS ENTER ON A BLANK FIELD.'
----------------------------------------------------

top
2007
Survey form view entire document:  text  image
AC04
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
What are the other reasons (PERSON) (do/does) not have a usual source of health care?
CODE ALL THAT APPLY.
NO OTHER REASONS ........................ 0
SELDOM OR NEVER GETS SICK ............... 1
RECENTLY MOVED INTO AREA ................ 2
DON'T KNOW WHERE TO GO FOR CARE ......... 3
USUAL SOURCE OF MEDICAL CARE IN THIS AREA IS NO LONGER AVAILABLE ........... 4
CAN'T FIND A PROVIDER WHO SPEAKS (PERSON)'S LANGUAGE ................... 5
LIKES TO GO TO DIFFERENT PLACES FOR DIFFERENT HEALTH NEEDS ................ 6
JUST CHANGED INSURANCE PLANS ............ 7
DON'T USE DOCTORS/TREAT MYSELF .......... 8
COST OF MEDICAL CARE .................... 9
OTHER REASON ............................ 91
REF ..................................... -7
DK ...................................... -8
[Code All That Apply]
PRESS F1 FOR DEFINITION OF USUAL SOURCE OF HEALTH CARE.
----------------------------------------------------
IF CODED '91' (OTHER REASON) ALONE OR IN COMBINATION WITH OTHER CODES, CONTINUE WITH AC04OV
----------------------------------------------------
----------------------------------------------------
OTHERWISE, GO TO END_LP01
----------------------------------------------------
----------------------------------------------------
EDIT: IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8 (DON'T KNOW) IN THE FIRST FIELD, NO OTHER REASON CATEGORY CAN BE CODED. IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8' (DON'T KNOW), IN A FIELD OTHER THAN THE FIRST FIELD AND A SUBSEQUENT CODE IS ENTERED, DISPLAY THE FOLLOWING MESSAGE: 'INVALID RESPONSE. PRESS ENTER ON A BLANK FIELD.'
----------------------------------------------------

top
2005
Survey form view entire document:  text  image
AC04
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
What are the other reasons (PERSON) (do/does) not have a usual source of health care?
CODE ALL THAT APPLY.
NO OTHER REASONS ........................ 0
SELDOM OR NEVER GETS SICK ............... 1
RECENTLY MOVED INTO AREA ................ 2
DON'T KNOW WHERE TO GO FOR CARE ......... 3
USUAL SOURCE OF MEDICAL CARE IN THIS AREA IS NO LONGER AVAILABLE ........... 4
CAN'T FIND A PROVIDER WHO SPEAKS (PERSON)'S LANGUAGE ................... 5
LIKES TO GO TO DIFFERENT PLACES FOR DIFFERENT HEALTH NEEDS ................ 6
JUST CHANGED INSURANCE PLANS ............ 7
DON'T USE DOCTORS/TREAT MYSELF .......... 8
COST OF MEDICAL CARE .................... 9
OTHER REASON ............................ 91
REF ..................................... -7
DK ...................................... -8
[Code All That Apply]
PRESS F1 FOR DEFINITION OF USUAL SOURCE OF HEALTH CARE.
----------------------------------------------------
IF CODED '91' (OTHER REASON) ALONE OR IN COMBINATION WITH OTHER CODES, CONTINUE WITH AC04OV
----------------------------------------------------
----------------------------------------------------
OTHERWISE, GO TO END_LP01
----------------------------------------------------
----------------------------------------------------
EDIT: IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8 (DON'T KNOW) IN THE FIRST FIELD, NO OTHER REASON CATEGORY CAN BE CODED. IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8' (DON'T KNOW), IN A FIELD OTHER THAN THE FIRST FIELD AND A SUBSEQUENT CODE IS ENTERED, DISPLAY THE FOLLOWING MESSAGE: 'INVALID RESPONSE. PRESS ENTER ON A BLANK FIELD.'
----------------------------------------------------

top
2002
Survey form view entire document:  text  image
AC04
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
What are the other reasons (PERSON) (do/does) not have a usual source of health care?
CODE ALL THAT APPLY.
NO OTHER REASONS ........................ 0
SELDOM OR NEVER GETS SICK ............... 1
RECENTLY MOVED INTO AREA ................ 2
DON'T KNOW WHERE TO GO FOR CARE ......... 3
USUAL SOURCE OF MEDICAL CARE IN THIS AREA IS NO LONGER AVAILABLE ........... 4
CAN'T FIND A PROVIDER WHO SPEAKS (PERSON)'S LANGUAGE ................... 5
LIKES TO GO TO DIFFERENT PLACES FOR DIFFERENT HEALTH NEEDS ................ 6
JUST CHANGED INSURANCE PLANS ............ 7
DON'T USE DOCTORS/TREAT MYSELF .......... 8
COST OF MEDICAL CARE .................... 9
OTHER REASON ............................ 91
REF ..................................... -7
DK ...................................... -8
[Code All That Apply]
PRESS F1 FOR DEFINITION OF USUAL SOURCE OF HEALTH CARE.
----------------------------------------------------
IF CODED '91' (OTHER REASON) ALONE OR IN COMBINATION WITH OTHER CODES, CONTINUE WITH AC04OV
----------------------------------------------------
----------------------------------------------------
OTHERWISE, GO TO END_LP01
----------------------------------------------------
----------------------------------------------------
EDIT: IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8 (DON'T KNOW) IN THE FIRST FIELD, NO OTHER REASON CATEGORY CAN BE CODED. IF CODED '0' (NO OTHER REASONS), '-7' (REFUSED), OR '-8' (DON'T KNOW), IN A FIELD OTHER THAN THE FIRST FIELD AND A SUBSEQUENT CODE IS ENTERED, DISPLAY THE FOLLOWING MESSAGE: 'INVALID RESPONSE. PRESS ENTER ON A BLANK FIELD.'
----------------------------------------------------