[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER.......]
SHOW CARD AC-1.
How difficult is it for (PERSON) to get to (PROVIDER)?
Would you say it is ...

very difficult, ........................ 1
somewhat difficult, .................... 2
not too difficult or ................... 3
not at all difficult? .................. 4
REF ................................... -7
DK .................................... -8
[Code One]

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER.......]
SHOW CARD AC-1.
How difficult is it for (PERSON) to get to (PROVIDER)?
Would you say it is ...

very difficult, ........................ 1
somewhat difficult, .................... 2
not too difficult or ................... 3
not at all difficult? .................. 4
REF ................................... -7
DK .................................... -8
[Code One]

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER.......]
SHOW CARD AC-1.
How difficult is it for (PERSON) to get to (PROVIDER)?
Would you say it is ...

very difficult, ........................ 1
somewhat difficult, .................... 2
not too difficult or ................... 3
not at all difficult? .................. 4
REF ................................... -7
DK .................................... -8
[Code One]

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER.......]
SHOW CARD AC-1.
How difficult is it for (PERSON) to get to (PROVIDER)?
Would you say it is ...

very difficult, ........................ 1
somewhat difficult, .................... 2
not too difficult or ................... 3
not at all difficult? .................. 4
REF ................................... -7
DK .................................... -8
[Code One]

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER.......]
SHOW CARD AC-1.
How difficult is it for (PERSON) to get to (PROVIDER)?
Would you say it is ...

very difficult, ........................ 1
somewhat difficult, .................... 2
not too difficult or ................... 3
not at all difficult? .................. 4
REF ................................... -7
DK .................................... -8
[Code One]

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER.......]
SHOW CARD AC-1.
How difficult is it for (PERSON) to get to (PROVIDER)?
Would you say it is ...

very difficult, ........................ 1
somewhat difficult, .................... 2
not too difficult or ................... 3
not at all difficult? .................. 4
REF ................................... -7
DK .................................... -8
[Code One]

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER.......]
SHOW CARD AC-1.
How difficult is it for (PERSON) to get to (PROVIDER)?
Would you say it is ...

very difficult, ........................ 1
somewhat difficult, .................... 2
not too difficult or ................... 3
not at all difficult? .................. 4
REF ................................... -7
DK .................................... -8
[Code One]

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER.......]
SHOW CARD AC-1.
How difficult is it for (PERSON) to get to (PROVIDER)?
Would you say it is ...

very difficult, ........................ 1
somewhat difficult, .................... 2
not too difficult or ................... 3
not at all difficult? .................. 4
REF ................................... -7
DK .................................... -8
[Code One]

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER.......]
SHOW CARD AC-1.
How difficult is it for (PERSON) to get to (PROVIDER)?
Would you say it is ...

very difficult, ........................ 1
somewhat difficult, .................... 2
not too difficult or ................... 3
not at all difficult? .................. 4
REF ................................... -7
DK .................................... -8
[Code One]

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER.......]
SHOW CARD AC-1.
How difficult is it for (PERSON) to get to (PROVIDER)?
Would you say it is ...

very difficult, ........................ 1
somewhat difficult, .................... 2
not too difficult or ................... 3
not at all difficult? .................. 4
REF ................................... -7
DK .................................... -8
[Code One]

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER.......]
SHOW CARD AC-1.
How difficult is it for (PERSON) to get to (PROVIDER)?
Would you say it is ...

very difficult, ........................ 1
somewhat difficult, .................... 2
not too difficult or ................... 3
not at all difficult? .................. 4
REF ................................... -7
DK .................................... -8
[Code One]

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER.......]
SHOW CARD AC-1.
How difficult is it for (PERSON) to get to (PROVIDER)?
Would you say it is ...

very difficult, ........................ 1
somewhat difficult, .................... 2
not too difficult or ................... 3
not at all difficult? .................. 4
REF ................................... -7
DK .................................... -8
[Code One]