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
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
2017
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
2016
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
2015
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
2014
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
2013
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
2012
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
2011
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
2010
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
2009
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
2008
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
2007
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
2006
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
2005
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
2004
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
2003
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
2002
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
2001
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
2000
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
1999
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
1998
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
1997
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------

top
1996
Survey form view entire document:  text  image
PM02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [STR-DT] [END-DT]
While we were talking about (PERSON)'s medical care, we listed the following prescription(s) as purchased or received since (START DATE). (READ MEDICINES BELOW.)
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
[NAME OF PRESCRIPTION MEDICINE.]
INFORMATION OKAY ....................... 1 [PM04]
AT LEAST ONE MEDICINE INCORRECT ........ 2
[Code One]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL MEDICINES IN THE PERSON'S-PRESCRIBED-MEDICINES- ROSTER THAT ARE FLAGGED AS EITHER 'CREATED' OR 'SELECTED' DURING THE CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS ONLY ONE MEDICINE ON PERSON'S-PRESCRIBED- MEDICINES-ROSTER, SELECT THAT MEDICINE AUTOMATICALLY BY CAPI AT PM03 AND GO TO PM04
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (AT LEAST ONE MEDICINE INCORRECT) AND THERE IS MORE THAN ONE MEDICINE ON PERSON'S- PRESCRIBED-MEDICINES-ROSTER, CONTINUE WITH PM03
----------------------------------------------------