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
PV40 (PV1035)
BLAISE NAME: MPTp
Context Header: (PERSON?S FIRST MIDDLE AND LAST NAME) (EV)
Question Text:
INTERVIEWER: SELECT WHETHER (EVENT TYPE) HEALTH CARE FOR (PERSON) WAS TO A PERSON OR A FACILITY.
Responses: 
PERSON-PROVIDER 1 PV50_01 (PV1040)
FACILITY-PROVIDER 2 PV60_01 (PV1085)
Programmer Instructions: Refused and Don?t Know are not allowed.
Display Instructions: 
Display ?MV? for ?EVENT TYPE? if the current event is MV. Display ?HH? for ?EVENT TYPE? if the current event is HH. Otherwise, use a null display.

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2017
Survey form view entire document:  text  image
PV01
====

[PERSON?S FIRST MIDDLE AND LAST NAME] [EV]
[[What is the name of the person or place that provided health care to [you/[PERSON]]?]]
INTERVIEWER: IS THE PROVIDER [ASSOCIATED WITH THIS EVENT] A PERSON OR A FACILITY (INCLUDING GROUP PRACTICES AND HMOs)?
[IF FACILITY NAMED, PROBE: If [you/[PERSON]] usually [see/sees] a particular person at this place, please give me the name of that person first.]
PERSON ................................. 1
FACILITY ............................... 2 [BOX_01]
HELP AVAILABLE FOR DEFINITION OF PERSON/FACILITY.
----------------------------------------------------
DISPLAY ?[What is ... [you/[PERSON]]?]? AND ?ASSOCIATED WITH THIS EVENT? IF THE PROVIDER ROSTER (PV) SECTION WAS NOT CALLED FROM THE ACCESSTO CARE (AC) SECTION. IF THE PV SECTION WAS CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
DISPLAY ?IF FACILITY NAMED, PROBE: ... person first.? IF THE PV SECTION WAS CALLED FROM THE AC SECTION. IF THE PV SECTION WAS NOT CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED ?1? (PERSON), SET PROVIDER TYPE TO ?PERSON-TYPE-PROVIDER?.
----------------------------------------------------
----------------------------------------------------
IF CODED ?2? (FACILITY), SET PROVIDER TYPE TO ?FACILITY-PROVIDER?.
----------------------------------------------------
----------------------------------------------------
IF NO PERSON-PROVIDERS ON RU-MEDICAL-PROVIDERS-ROSTER AND PV01 IS CODED ?1?, THEN CREATE A NEW PROV RECORD.
----------------------------------------------------
----------------------------------------------------
IF CODED ?1? (PERSON) AND NO PROVIDERS THAT ARE TYPE ?PERSON-PROVIDER? ON RU-MEDICAL-PROVIDERS-ROSTER, GO TO PV04
----------------------------------------------------
----------------------------------------------------
IF CODED ?1? (PERSON) AND AT LEAST ONE PROVIDER THAT IS TYPE ?PERSON-PROVIDER? ON RU-MEDICAL-PROVIDERS-ROSTER, CONTINUE WITH PV02
----------------------------------------------------
----------------------------------------------------
HARD CHECK: IF EVENT TYPE IS HS, ER, OP, OR IC, PV01 CANNOT BE CODED ?1? (PERSON). IF PV01 IS CODED ?1? (PERSON) FOR AN HS, ER, OP, OR IC EVENT,THE ERROR HANDLER WILL FORCE THE INTERVIEWER TO RECTIFY THE DATA.
----------------------------------------------------

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2016
Survey form view entire document:  text  image
PV01
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV]
[[What is the name of the person or place that provided health care to [you/[PERSON]]?]]
INTERVIEWER: IS THE PROVIDER [ASSOCIATED WITH THIS EVENT] A PERSON OR A FACILITY (INCLUDING GROUP PRACTICES AND HMOs)?
[IF FACILITY NAMED, PROBE: If [you/[PERSON]] usually [see/sees] a particular person at this place, please give me the name of that person first.]
PERSON ................................. 1
FACILITY ............................... 2 [BOX_01]
HELP AVAILABLE FOR DEFINITION OF PERSON/FACILITY.
----------------------------------------------------
DISPLAY '[What is ... [you/[PERSON]]?]' AND 'ASSOCIATED WITH THIS EVENT' IF THE PROVIDER ROSTER (PV) SECTION WAS NOT CALLED FROM THE ACCESS TO CARE (AC) SECTION. IF THE PV SECTION WAS CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
DISPLAY 'IF FACILITY NAMED, PROBE: ... person first.' IF THE PV SECTION WAS CALLED FROM THE AC SECTION. IF THE PV SECTION WAS NOT CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON), SET PROVIDER TYPE TO 'PERSON-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (FACILITY), SET PROVIDER TYPE TO 'FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF NO PERSON-PROVIDERS ON RU-MEDICAL-PROVIDERS- ROSTER AND PV01 IS CODED '1', THEN CREATE A NEW PROV RECORD.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND NO PROVIDERS THAT ARE TYPE 'PERSON-PROVIDER' ON RU-MEDICAL-PROVIDERS- ROSTER, GO TO PV04
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND AT LEAST ONE PROVIDER THAT IS TYPE 'PERSON-PROVIDER' ON RU-MEDICAL- PROVIDERS-ROSTER, CONTINUE WITH PV02
----------------------------------------------------
----------------------------------------------------
HARD CHECK: IF EVENT TYPE IS HS, ER, OP, OR IC, PV01 CANNOT BE CODED '1' (PERSON). IF PV01 IS CODED '1' (PERSON) FOR AN HS, ER, OP, OR IC EVENT, THE ERROR HANDLER WILL FORCE THE INTERVIEWER TO RECTIFY THE DATA.

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2015
Survey form view entire document:  text  image
PV01
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV]
[[What is the name of the person or place that provided health care to [you/[PERSON]]?]]
INTERVIEWER: IS THE PROVIDER [ASSOCIATED WITH THIS EVENT] A PERSON OR A FACILITY (INCLUDING GROUP PRACTICES AND HMOs)?
[IF FACILITY NAMED, PROBE: If [you/[PERSON]] usually [see/sees] a particular person at this place, please give me the name of that person first.]
PERSON ................................. 1
FACILITY ............................... 2 [BOX_01]
HELP AVAILABLE FOR DEFINITION OF PERSON/FACILITY.
----------------------------------------------------
DISPLAY '[What is ... [you/[PERSON]]?]' AND 'ASSOCIATED WITH THIS EVENT' IF THE PROVIDER ROSTER (PV) SECTION WAS NOT CALLED FROM THE ACCESS TO CARE (AC) SECTION. IF THE PV SECTION WAS CALLED FROM THE AC SECTION, USE A NULL DISPLAY.

DISPLAY 'IF FACILITY NAMED, PROBE: ... person first.' IF THE PV SECTION WAS CALLED FROM THE AC SECTION. IF THE PV SECTION WAS NOT CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON), SET PROVIDER TYPE TO 'PERSON-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (FACILITY), SET PROVIDER TYPE TO 'FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF NO PERSON-PROVIDERS ON RU-MEDICAL-PROVIDERS- ROSTER AND PV01 IS CODED '1', THEN CREATE A NEW PROV RECORD.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND NO PROVIDERS THAT ARE TYPE 'PERSON-PROVIDER' ON RU-MEDICAL-PROVIDERS- ROSTER, GO TO PV04
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND AT LEAST ONE PROVIDER THAT IS TYPE 'PERSON-PROVIDER' ON RU-MEDICAL- PROVIDERS-ROSTER, CONTINUE WITH PV02
----------------------------------------------------
----------------------------------------------------
HARD CHECK: IF EVENT TYPE IS HS, ER, OP, OR IC, PV01 CANNOT BE CODED '1' (PERSON). IF PV01 IS CODED '1' (PERSON) FOR AN HS, ER, OP, OR IC EVENT, THE ERROR HANDLER WILL FORCE THE INTERVIEWER TO RECTIFY THE DATA.
----------------------------------------------------

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2014
Survey form view entire document:  text  image
PV01
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV]
[[What is the name of the person or place that provided health care to [you/[PERSON]]?]] INTERVIEWER: IS THE PROVIDER [ASSOCIATED WITH THIS EVENT] A PERSON OR A FACILITY (INCLUDING GROUP PRACTICES AND HMOs)? [IF FACILITY NAMED, PROBE: If [you/[PERSON]] usually [see/sees] a particular person at this place, please give me the name of that person first.]
PERSON ................................. 1
FACILITY ............................... 2 [BOX_01]
HELP AVAILABLE FOR DEFINITION OF PERSON/FACILITY.
----------------------------------------------------
DISPLAY '[What is ... [you/[PERSON]]?]' AND 'ASSOCIATED WITH THIS EVENT' IF THE PROVIDER ROSTER (PV) SECTION WAS NOT CALLED FROM THE ACCESSTO CARE (AC) SECTION. IF THE PV SECTION WAS CALLED FROM THE AC SECTION, USE A NULL DISPLAY.

DISPLAY 'IF FACILITY NAMED, PROBE: ... person first.' IF THE PV SECTION WAS CALLED FROM THE AC SECTION. IF THE PV SECTION WAS NOT CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON), SET PROVIDER TYPE TO 'PERSON-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (FACILITY), SET PROVIDER TYPE TO 'FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF NO PERSON-PROVIDERS ON RU-MEDICAL-PROVIDERS- ROSTER AND PV01 IS CODED '1', THEN CREATE A NEW PROV RECORD.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND NO PROVIDERS THAT ARE TYPE 'PERSON-PROVIDER' ON RU-MEDICAL-PROVIDERS- ROSTER, GO TO PV04
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND AT LEAST ONE PROVIDER THAT IS TYPE 'PERSON-PROVIDER' ON RU-MEDICAL- PROVIDERS-ROSTER, CONTINUE WITH PV02
----------------------------------------------------
----------------------------------------------------
HARD CHECK: IF EVENT TYPE IS HS, ER, OP, OR IC, PV01 CANNOT BE CODED '1' (PERSON). IF PV01 IS CODED '1' (PERSON) FOR AN HS, ER, OP, OR IC EVENT, THE ERROR HANDLER WILL FORCE THE INTERVIEWER TO RECTIFY THE DATA.
----------------------------------------------------

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2013
Survey form view entire document:  text  image
AC11
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......]
ASK IF NOT OBVIOUS.
[Is [PROVIDER]/Does [PROVIDER] work at] a clinic in a hospital, a hospital outpatient department, an emergency room at a hospital, or some other kind of place?
HOSPITAL CLINIC OR OUTPATIENT DEPARTMENT ............................ 1 [AC12]
HOSPITAL EMERGENCY ROOM ................. 2 [AC12]
OTHER KIND OF PLACE ..................... 3 [AC12]
REF ..................................... -7 [AC12]
DK ...................................... -8 [AC12]
[Code One]
HELP AVAILABLE FOR DEFINITIONS OF ANSWER CATEGORIES.
----------------------------------------------------
DISPLAY 'Is [PROVIDER]' IF USC PROVIDER IS FLAGGED AS 'FACILITY-TYPE-PROVIDER'. DISPLAY 'Does [PROVIDER] work at' IF USC PROVIDER IS FLAGGED AS 'PERSON-IN-FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
NOTE: FOR QUESTIONS AC11 ? AC20, THE CONTEXT HEADER WILL DISPLAY THE PERSON-PROVIDER NAME IF THE USC PROVIDER BEING ASKED ABOUT IS FLAGGED AS 'PERSON-TYPE-PROVIDER' OR 'PERSON-IN-FACILITY- PROVIDER'. IF THE USC PROVIDER BEING ASKED ABOUT IS FLAGGED AS 'FACILITY-TYPE-PROVIDER', THE CONTEXT HEADER WILL DISPLAY THE FACILITY-PROVIDER NAME.
----------------------------------------------------

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2012
Survey form view entire document:  text  image
PV01
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV]
[[What is the name of the person or place that provided health care to [you/[PERSON]]?]]
INTERVIEWER: IS THE PROVIDER [ASSOCIATED WITH THIS EVENT] A PERSON OR A FACILITY (INCLUDING GROUP PRACTICES AND HMOs)?
[IF FACILITY NAMED, PROBE: If [you/[PERSON]] usually [see/sees] a particular person at this place, please give me the name of that person first.]
PERSON ................................. 1
FACILITY ............................... 2 [BOX_01]
HELP AVAILABLE FOR DEFINITION OF PERSON/FACILITY.
----------------------------------------------------
DISPLAY '[What is ... [you/[PERSON]]?]' AND 'ASSOCIATED WITH THIS EVENT' IF THE PROVIDER ROSTER (PV) SECTION WAS NOT CALLED FROM THE ACCESS TO CARE (AC) SECTION. IF THE PV SECTION WAS CALLED FROM THE AC SECTION, USE A NULL DISPLAY.

DISPLAY 'IF FACILITY NAMED, PROBE: ... person first.' IF THE PV SECTION WAS CALLED FROM THE AC SECTION. IF THE PV SECTION WAS NOT CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON), SET PROVIDER TYPE TO 'PERSON-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (FACILITY), SET PROVIDER TYPE TO 'FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF NO PERSON-PROVIDERS ON RU-MEDICAL-PROVIDERS- ROSTER AND PV01 IS CODED '1', THEN CREATE A NEW PROV RECORD.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND NO PROVIDERS THAT ARE TYPE 'PERSON-PROVIDER' ON RU-MEDICAL-PROVIDERS- ROSTER, GO TO PV04
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND AT LEAST ONE PROVIDER THAT IS TYPE 'PERSON-PROVIDER' ON RU-MEDICAL- PROVIDERS-ROSTER, CONTINUE WITH PV02
----------------------------------------------------
----------------------------------------------------
HARD CHECK: IF EVENT TYPE IS HS, ER, OP, OR IC, PV01 CANNOT BE CODED '1' (PERSON). IF PV01 IS CODED '1' (PERSON) FOR AN HS, ER, OP, OR IC EVENT, THE ERROR HANDLER WILL FORCE THE INTERVIEWER TO RECTIFY THE DATA.
----------------------------------------------------

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2011
Survey form view entire document:  text  image
PV01
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV]
[[What is the name of the person or place that provided health care to (PERSON)?]]
INTERVIEWER: IS THE PROVIDER [ASSOCIATED WITH THIS EVENT] A PERSON OR A FACILITY (INCLUDING GROUP PRACTICES AND HMOs)?
[IF FACILITY NAMED, PROBE: If (PERSON) usually (see/sees) a particular person at this place, please give me the name of that person first.]
PERSON ................................. 1
FACILITY ............................... 2 [BOX_01]
HELP AVAILABLE FOR DEFINITION OF PERSON/FACILITY.
----------------------------------------------------
DISPLAY '[What is ... (PERSON)?]' AND 'ASSOCIATED WITH THIS EVENT' IF THE PROVIDER ROSTER (PV) SECTION WAS NOT CALLED FROM THE ACCESS TO CARE (AC) SECTION. IF THE PV SECTION WAS CALLED FROM THE AC SECTION, USE A NULL DISPLAY.

DISPLAY 'IF FACILITY NAMED, PROBE: ... person first.' IF THE PV SECTION WAS CALLED FROM THE AC SECTION. IF THE PV SECTION WAS NOT CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON), SET PROVIDER TYPE TO 'PERSON-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (FACILITY), SET PROVIDER TYPE TO 'FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF NO PERSON-PROVIDERS ON RU-MEDICAL-PROVIDERS- ROSTER AND PV01 IS CODED '1', THEN CREATE A NEW PROV RECORD.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND NO PROVIDERS THAT ARE TYPE 'PERSON-PROVIDER' ON RU-MEDICAL-PROVIDERS- ROSTER, GO TO PV04
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND AT LEAST ONE PROVIDER THAT IS TYPE 'PERSON-PROVIDER' ON RU-MEDICAL- PROVIDERS-ROSTER, CONTINUE WITH PV02
----------------------------------------------------
----------------------------------------------------
HARD CHECK: IF EVENT TYPE IS HS, ER, OP, OR IC, PV01 CANNOT BE CODED '1' (PERSON). IF PV01 IS CODED '1' (PERSON) FOR AN HS, ER, OP, OR IC EVENT, THE ERROR HANDLER WILL FORCE THE INTERVIEWER TO RECTIFY THE DATA.
----------------------------------------------------

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2010
Survey form view entire document:  text  image
PV01
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV]
[[What is the name of the person or place that provided health care to (PERSON)?]]
INTERVIEWER: IS THE PROVIDER [ASSOCIATED WITH THIS EVENT] A PERSON OR A FACILITY (INCLUDING GROUP PRACTICES AND HMOs)?
[IF FACILITY NAMED, PROBE: If (PERSON) usually (see/sees) a particular person at this place, please give me the name of that person first.]
PERSON ................................. 1
FACILITY ............................... 2 [BOX_01]
HELP AVAILABLE FOR DEFINITION OF PERSON/FACILITY.
----------------------------------------------------
DISPLAY '[What is ... (PERSON)?]' AND 'ASSOCIATED WITH THIS EVENT' IF THE PROVIDER ROSTER (PV) SECTION WAS NOT CALLED FROM THE ACCESS TO CARE (AC) SECTION. IF THE PV SECTION WAS CALLED FROM THE AC SECTION, USE A NULL DISPLAY.

DISPLAY 'IF FACILITY NAMED, PROBE: ... person first.' IF THE PV SECTION WAS CALLED FROM THE AC SECTION. IF THE PV SECTION WAS NOT CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON), SET PROVIDER TYPE TO 'PERSON-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (FACILITY), SET PROVIDER TYPE TO 'FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF NO PERSON-PROVIDERS ON RU-MEDICAL-PROVIDERS- ROSTER AND PV01 IS CODED '1', THEN CREATE A NEW PROV RECORD.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND NO PROVIDERS THAT ARE TYPE 'PERSON-PROVIDER' ON RU-MEDICAL-PROVIDERS- ROSTER, GO TO PV04
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND AT LEAST ONE PROVIDER THAT IS TYPE 'PERSON-PROVIDER' ON RU-MEDICAL- PROVIDERS-ROSTER, CONTINUE WITH PV02
----------------------------------------------------
----------------------------------------------------
HARD CHECK: IF EVENT TYPE IS HS, ER, OP, OR IC, PV01 CANNOT BE CODED '1' (PERSON). IF PV01 IS CODED '1' (PERSON) FOR AN HS, ER, OP, OR IC EVENT, THE ERROR HANDLER WILL FORCE THE INTERVIEWER TO RECTIFY THE DATA.
----------------------------------------------------

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2009
Survey form view entire document:  text  image
PV01
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV]
[[What is the name of the person or place that provided health care to (PERSON)?]] INTERVIEWER: IS THE PROVIDER [ASSOCIATED WITH THIS EVENT] A PERSON OR A FACILITY (INCLUDING GROUP PRACTICES AND HMOs)?
[IF FACILITY NAMED, PROBE: If (PERSON) usually (see/sees) a particular person at this place, please give me the name of that person first.]
PERSON ................................. 1
FACILITY ............................... 2 [BOX_01]
HELP AVAILABLE FOR DEFINITION OF PERSON/FACILITY.
----------------------------------------------------
DISPLAY '[What is ... (PERSON)?]' AND 'ASSOCIATED WITH THIS EVENT' IF THE PROVIDER ROSTER (PV) SECTION WAS NOT CALLED FROM THE ACCESS TO CARE (AC) SECTION. IF THE PV SECTION WAS CALLED FROM THE AC SECTION, USE A NULL DISPLAY.

DISPLAY 'IF FACILITY NAMED, PROBE: ... person first.' IF THE PV SECTION WAS CALLED FROM THE AC SECTION. IF THE PV SECTION WAS NOT CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON), SET PROVIDER TYPE TO 'PERSON-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (FACILITY), SET PROVIDER TYPE TO 'FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF NO PERSON-PROVIDERS ON RU-MEDICAL-PROVIDERS- ROSTER AND PV01 IS CODED '1', THEN CREATE A NEW PROV RECORD.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND NO PROVIDERS THAT ARE TYPE 'PERSON-PROVIDER' ON RU-MEDICAL-PROVIDERS- ROSTER, GO TO PV04
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND AT LEAST ONE PROVIDER THAT IS TYPE 'PERSON-PROVIDER' ON RU-MEDICAL- PROVIDERS-ROSTER, CONTINUE WITH PV02
----------------------------------------------------
----------------------------------------------------
HARD CHECK: IF EVENT TYPE IS HS, ER, OP, OR IC, PV01 CANNOT BE CODED '1' (PERSON). IF PV01 IS CODED '1' (PERSON) FOR AN HS, ER, OP, OR IC EVENT, THE ERROR HANDLER WILL FORCE THE INTERVIEWER TO RECTIFY THE DATA.
----------------------------------------------------

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2008
Survey form view entire document:  text  image
PV01
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV]
[[What is the name of the person or place that provided health care to (PERSON)?]] INTERVIEWER: IS THE PROVIDER [ASSOCIATED WITH THIS EVENT] A PERSON OR A FACILITY (INCLUDING GROUP PRACTICES AND HMOs)?
[IF FACILITY NAMED, PROBE: If (PERSON) usually (see/sees) a particular person at this place, please give me the name of that person first.]
PERSON ................................. 1
FACILITY ............................... 2 [BOX_01]
HELP AVAILABLE FOR DEFINITION OF PERSON/FACILITY.
----------------------------------------------------
DISPLAY '[What is ... (PERSON)?]' AND 'ASSOCIATED WITH THIS EVENT' IF THE PROVIDER ROSTER (PV) SECTION WAS NOT CALLED FROM THE ACCESS TO CARE (AC) SECTION. IF THE PV SECTION WAS CALLED FROM THE AC SECTION, USE A NULL DISPLAY.

DISPLAY 'IF FACILITY NAMED, PROBE: ... person first.' IF THE PV SECTION WAS CALLED FROM THE AC SECTION. IF THE PV SECTION WAS NOT CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON), SET PROVIDER TYPE TO 'PERSON-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (FACILITY), SET PROVIDER TYPE TO 'FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF NO PERSON-PROVIDERS ON RU-MEDICAL-PROVIDERS- ROSTER AND PV01 IS CODED '1', THEN CREATE A NEW PROV RECORD.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND NO PROVIDERS THAT ARE TYPE 'PERSON-PROVIDER' ON RU-MEDICAL-PROVIDERS- ROSTER, GO TO PV04
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND AT LEAST ONE PROVIDER THAT IS TYPE 'PERSON-PROVIDER' ON RU-MEDICAL- PROVIDERS-ROSTER, CONTINUE WITH PV02
----------------------------------------------------
----------------------------------------------------
HARD CHECK: IF EVENT TYPE IS HS, ER, OP, OR IC, PV01 CANNOT BE CODED '1' (PERSON). IF PV01 IS CODED '1' (PERSON) FOR AN HS, ER, OP, OR IC EVENT, THE ERROR HANDLER WILL FORCE THE INTERVIEWER TO RECTIFY THE DATA.
----------------------------------------------------

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2007
Survey form view entire document:  text  image
PV01
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV]
[[What is the name of the person or place that provided health care to (PERSON)?]]
INTERVIEWER: IS THE PROVIDER [ASSOCIATED WITH THIS EVENT] A PERSON OR A FACILITY (INCLUDING GROUP PRACTICES AND HMOs)?
PERSON ................................. 1
FACILITY ............................... 2 [BOX_01]
PRESS F1 FOR DEFINITION OF PERSON/FACILITY.
----------------------------------------------------
DISPLAY '[What is ... (PERSON)?]' AND 'ASSOCIATED WITH THIS EVENT' IF THE PROVIDER ROSTER (PV) SECTION WAS NOT CALLED FROM THE ACCESS TO CARE (AC) SECTION. IF THE PV SECTION WAS CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON), SET PROVIDER TYPE TO 'PERSON-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (FACILITY), SET PROVIDER TYPE TO 'FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND NO PROVIDERS THAT ARE TYPE 'PERSON-TYPE-PROVIDER' ON RU-MEDICAL-PROVIDERS-ROSTER, GO TO PV04
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND AT LEAST ONE PROVIDER THAT IS TYPE 'PERSON-TYPE-PROVIDER' ON RU-MEDICAL-PROVIDERS-ROSTER, CONTINUE WITH PV02
----------------------------------------------------
----------------------------------------------------EDIT: IF EVENT TYPE IS HS, ER, OP, OR IC, PV01 CANNOT BE CODED '1' (PERSON). IF PV01 IS CODED '1' (PERSON) FOR AN HS, ER, OP, OR IC EVENT, DISPLAY THE FOLLOWING MESSAGE: 'A FACILITY MUST BE ASSOCIATED WITH [EV] TYPE. VERIFY PROVIDER AND RE-ENTER.'
----------------------------------------------------

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2006
Survey form view entire document:  text  image
PV01
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV]
[[What is the name of the person or place that provided health care to (PERSON)?]]
INTERVIEWER: IS THE PROVIDER [ASSOCIATED WITH THIS EVENT] A PERSON OR A FACILITY (INCLUDING GROUP PRACTICES AND HMOs)?
PERSON ................................. 1
FACILITY ............................... 2 [BOX_01]
PRESS F1 FOR DEFINITION OF PERSON/FACILITY.
----------------------------------------------------
DISPLAY '[What is ... (PERSON)?]' AND 'ASSOCIATED WITH THIS EVENT' IF THE PROVIDER ROSTER (PV) SECTION WAS NOT CALLED FROM THE ACCESS TO CARE (AC) SECTION. IF THE PV SECTION WAS CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON), SET PROVIDER TYPE TO 'PERSON-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (FACILITY), SET PROVIDER TYPE TO 'FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND NO PROVIDERS THAT ARE TYPE 'PERSON-TYPE-PROVIDER' ON RU-MEDICAL-PROVIDERS-ROSTER, GO TO PV04
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND AT LEAST ONE PROVIDER THAT IS TYPE 'PERSON-TYPE-PROVIDER' ON RU-MEDICAL-PROVIDERS-ROSTER, CONTINUE WITH PV02
----------------------------------------------------
----------------------------------------------------
EDIT: IF EVENT TYPE IS HS, ER, OP, OR IC, PV01 CANNOT BE CODED '1' (PERSON). IF PV01 IS CODED '1' (PERSON) FOR AN HS, ER, OP, OR IC EVENT, DISPLAY THE FOLLOWING MESSAGE: 'A FACILITY MUST BE ASSOCIATED WITH [EV] TYPE. VERIFY PROVIDER AND RE-ENTER.'
----------------------------------------------------

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2005
Survey form view entire document:  text  image
PV01
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV]
[[What is the name of the person or place that provided health care to (PERSON)?]]
INTERVIEWER: IS THE PROVIDER [ASSOCIATED WITH THIS EVENT] A PERSON OR A FACILITY (INCLUDING GROUP PRACTICES AND HMOs)?
PERSON ................................. 1
FACILITY ............................... 2 [BOX_01]
PRESS F1 FOR DEFINITION OF PERSON/FACILITY.
----------------------------------------------------
DISPLAY ?[What is ... (PERSON)?]? AND ?ASSOCIATED WITH THIS EVENT? IF THE PROVIDER ROSTER (PV) SECTION WAS NOT CALLED FROM THE ACCESS TO CARE (AC) SECTION. IF THE PV SECTION WAS CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED ?1? (PERSON), SET PROVIDER TYPE TO ?PERSON-TYPE-PROVIDER?.
----------------------------------------------------
----------------------------------------------------
IF CODED ?2? (FACILITY), SET PROVIDER TYPE TO ?FACILITY-PROVIDER?.
----------------------------------------------------
----------------------------------------------------
IF CODED ?1? (PERSON) AND NO PROVIDERS THAT ARE TYPE ?PERSON-TYPE-PROVIDER? ON RU-MEDICAL-PROVIDERS-ROSTER, GO TO PV04
----------------------------------------------------
----------------------------------------------------
IF CODED ?1? (PERSON) AND AT LEAST ONE PROVIDER THAT IS TYPE ?PERSON-TYPE-PROVIDER? ON RU-MEDICAL-PROVIDERS-ROSTER, CONTINUE WITH PV02
----------------------------------------------------
----------------------------------------------------
EDIT: IF EVENT TYPE IS HS, ER, OP, OR IC, PV01 CANNOT BE CODED ?1? (PERSON). IF PV01 IS CODED ?1? (PERSON) FOR AN HS, ER, OP, OR IC EVENT, DISPLAY THE FOLLOWING MESSAGE: ?A FACILITY MUST BE ASSOCIATED WITH [EV] TYPE. VERIFY PROVIDER AND RE-ENTER.?
----------------------------------------------------

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2004
Survey form view entire document:  text  image

Provider Roster (PV) Section

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2003
Survey form view entire document:  text  image
AC06
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......]
ASK IF NOT OBVIOUS.
[Is (PROVIDER)/Does (PROVIDER) work at] a clinic in a hospital, a hospital outpatient department, an emergency room at a hospital, or some other kind of place?
HOSPITAL CLINIC OR OUTPATIENT DEPARTMENT ............................ 1
HOSPITAL EMERGENCY ROOM ................. 2 [BOX_03]
OTHER KIND OF PLACE ..................... 3 [BOX_03]
REF ..................................... -7 [BOX_03]
DK ...................................... -8 [BOX_03]
[Code One]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
----------------------------------------------------
DISPLAY 'Is (PROVIDER)' IF USC PROVIDER IS FLAGGED AS 'FACILITY-TYPE-PROVIDER'. DISPLAY 'Does (PROVIDER) work at' IF USC PROVIDER IS FLAGGED AS 'PERSON-IN-FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (HOSPITAL EMERGENCY ROOM), FLAG THIS USC PROVIDER AS 'HOSPITAL BASED'.
----------------------------------------------------
----------------------------------------------------
NOTE: FOR QUESTIONS AC06 - AC12, THE CONTEXT HEADER WILL DISPLAY THE PERSON-PROVIDER NAME IF THE USC PROVIDER BEING ASKED ABOUT IS FLAGGED AS 'PERSON-TYPE-PROVIDER' OR 'PERSON-IN-FACILITY- PROVIDER'. IF THE USC PROVIDER BEING ASKED ABOUT IS FLAGGED AS 'FACILITY-TYPE-PROVIDER', THE CONTEXT HEADER WILL DISPLAY THE FACILITY-PROVIDER NAME.
----------------------------------------------------

top
2002
Survey form view entire document:  text  image
PV01
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV]
[[What is the name of the person or place that provided health care to (PERSON)?]]
INTERVIEWER: IS THE PROVIDER [ASSOCIATED WITH THIS EVENT] A PERSON OR A FACILITY (INCLUDING GROUP PRACTICES AND HMOs)?
PERSON ................................. 1
FACILITY ............................... 2 [BOX_01]
PRESS F1 FOR DEFINITION OF PERSON/FACILITY.
----------------------------------------------------
DISPLAY '[What is ... (PERSON)?]' AND 'ASSOCIATED WITH THIS EVENT' IF THE PROVIDER ROSTER (PV) SECTION WAS NOT CALLED FROM THE ACCESS TO CARE (AC) SECTION. IF THE PV SECTION WAS CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON), SET PROVIDER TYPE TO 'PERSON-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (FACILITY), SET PROVIDER TYPE TO 'FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND NO PROVIDERS THAT ARE TYPE 'PERSON-TYPE-PROVIDER' ON RU-MEDICAL-PROVIDERS-ROSTER, GO TO PV04
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND AT LEAST ONE PROVIDER THAT IS TYPE 'PERSON-TYPE-PROVIDER' ON RU-MEDICAL-PROVIDERS-ROSTER, CONTINUE WITH PV02
----------------------------------------------------
----------------------------------------------------
EDIT: IF EVENT TYPE IS HS, ER, OP, OR IC, PV01 CANNOT BE CODED '1' (PERSON). IF PV01 IS CODED '1' (PERSON) FOR AN HS, ER, OP, OR IC EVENT, DISPLAY THE FOLLOWING MESSAGE: 'A FACILITY MUST BE ASSOCIATED WITH [EV] TYPE. VERIFY PROVIDER AND RE-ENTER.'
----------------------------------------------------

top
2001
Survey form view entire document:  text  image
PV01
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV]
[[What is the name of the person or place that provided health care to (PERSON)?]]
INTERVIEWER: IS THE PROVIDER [ASSOCIATED WITH THIS EVENT] A PERSON OR A FACILITY (INCLUDING GROUP PRACTICES AND HMOs)?
PERSON ................................. 1
FACILITY ............................... 2 [BOX_01]
PRESS F1 FOR DEFINITION OF PERSON/FACILITY.
----------------------------------------------------
DISPLAY '[What is ... (PERSON)?]' AND 'ASSOCIATED WITH THIS EVENT' IF THE PROVIDER ROSTER (PV) SECTION WAS NOT CALLED FROM THE ACCESS TO CARE (AC) SECTION. IF THE PV SECTION WAS CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON), SET PROVIDER TYPE TO 'PERSON-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (FACILITY), SET PROVIDER TYPE TO 'FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND NO PROVIDERS THAT ARE TYPE 'PERSON-TYPE-PROVIDER' ON RU-MEDICAL-PROVIDERS-ROSTER, GO TO PV04
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND AT LEAST ONE PROVIDER THAT IS TYPE 'PERSON-TYPE-PROVIDER' ON RU-MEDICAL-PROVIDERS-ROSTER, CONTINUE WITH PV02
----------------------------------------------------
----------------------------------------------------
EDIT: IF EVENT TYPE IS HS, ER, OP, OR IC, PV01 CANNOT BE CODED '1' (PERSON). IF PV01 IS CODED '1' (PERSON) FOR AN HS, ER, OP, OR IC EVENT, DISPLAY THE FOLLOWING MESSAGE: 'A FACILITY MUST BE ASSOCIATED WITH [EV] TYPE. VERIFY PROVIDER AND RE-ENTER.'
----------------------------------------------------

top
2000
Survey form view entire document:  text  image
PV01
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV]
[[What is the name of the person or place that provided health care to (PERSON)?]]
INTERVIEWER: IS THE PROVIDER [ASSOCIATED WITH THIS EVENT] A PERSON OR A FACILITY (INCLUDING GROUP PRACTICES AND HMOs)?
PERSON ................................. 1
FACILITY ............................... 2 [BOX_01]
PRESS F1 FOR DEFINITION OF PERSON/FACILITY.
----------------------------------------------------
DISPLAY '[What is ... (PERSON)?]' AND 'ASSOCIATED WITH THIS EVENT' IF THE PROVIDER ROSTER (PV) SECTION WAS NOT CALLED FROM THE ACCESS TO CARE (AC) SECTION. IF THE PV SECTION WAS CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON), SET PROVIDER TYPE TO 'PERSON-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (FACILITY), SET PROVIDER TYPE TO 'FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND NO PROVIDERS THAT ARE TYPE 'PERSON-TYPE-PROVIDER' ON RU-MEDICAL-PROVIDERS-ROSTER, GO TO PV04
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND AT LEAST ONE PROVIDER THAT IS TYPE 'PERSON-TYPE-PROVIDER' ON RU-MEDICAL-PROVIDERS-ROSTER, CONTINUE WITH PV02
----------------------------------------------------
----------------------------------------------------
EDIT: IF EVENT TYPE IS HS, ER, OP, OR IC, PV01 CANNOT BE CODED '1' (PERSON). IF PV01 IS CODED '1' (PERSON) FOR AN HS, ER, OP, OR IC EVENT, DISPLAY THE FOLLOWING MESSAGE: 'A FACILITY MUST BE ASSOCIATED WITH [EV] TYPE. VERIFY PROVIDER AND RE-ENTER.'
----------------------------------------------------

top
1999
Survey form view entire document:  text  image
PV01
====

PERSON'S FIRST MIDDLE AND LAST NAME] EV]
[What is the name of the person or place that provided health care to (PERSON)?]]
INTERVIEWER: IS THE PROVIDER ASSOCIATED WITH THIS EVENT] A PERSON OR A FACILITY (INCLUDING GROUP PRACTICES AND HMOs)?
PERSON ................................. 1
FACILITY ............................... 2 BOX_01]
PRESS F1 FOR DEFINITION OF PERSON/FACILITY.
----------------------------------------------------
DISPLAY '[What is ... (PERSON)?]' AND 'ASSOCIATED WITH THIS EVENT' IF THE PROVIDER ROSTER (PV) SECTION WAS NOT CALLED FROM THE ACCESS TO CARE (AC) SECTION. IF THE PV SECTION WAS CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON), SET PROVIDER TYPE TO 'PERSON-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (FACILITY), SET PROVIDER TYPE TO 'FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND NO PROVIDERS THAT ARE TYPE 'PERSON-TYPE-PROVIDER' ON RU-MEDICAL-PROVIDERS-ROSTER, GO TO PV04
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND AT LEAST ONE PROVIDER THAT IS TYPE 'PERSON-TYPE-PROVIDER' ON RU-MEDICAL-PROVIDERS-ROSTER, CONTINUE WITH PV02
----------------------------------------------------
----------------------------------------------------
EDIT: IF EVENT TYPE IS HS, ER, OP, OR IC, PV01 CANNOT BE CODED '1' (PERSON). IF PV01 IS CODED '1' (PERSON) FOR AN HS, ER, OP, OR IC EVENT, DISPLAY THE FOLLOWING MESSAGE: 'A FACILITY MUST BE ASSOCIATED WITH EV] TYPE. VERIFY PROVIDER AND RE-ENTER.'
----------------------------------------------------

top
1998
Survey form view entire document:  text  image
PV01
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV]
[[What is the name of the person or place that provided health care to (PERSON)?]]
INTERVIEWER: IS THE PROVIDER [ASSOCIATED WITH THIS EVENT] A PERSON OR A FACILITY (INCLUDING GROUP PRACTICES AND HMOs)?
PERSON ................................. 1
FACILITY ............................... 2 [BOX_01]
PRESS F1 FOR DEFINITION OF PERSON/FACILITY.
----------------------------------------------------
DISPLAY '[What is ... (PERSON)?]' AND 'ASSOCIATED WITH THIS EVENT' IF THE PROVIDER ROSTER (PV) SECTION WAS NOT CALLED FROM THE ACCESS TO CARE (AC) SECTION. IF THE PV SECTION WAS CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON), SET PROVIDER TYPE TO 'PERSON-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (FACILITY), SET PROVIDER TYPE TO 'FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND NO PROVIDERS THAT ARE TYPE 'PERSON-TYPE-PROVIDER' ON RU-MEDICAL-PROVIDERS-ROSTER, GO TO PV04
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND AT LEAST ONE PROVIDER THAT IS TYPE 'PERSON-TYPE-PROVIDER' ON RU-MEDICAL-PROVIDERS-ROSTER, CONTINUE WITH PV02
----------------------------------------------------
----------------------------------------------------
EDIT: IF EVENT TYPE IS HS, ER, OP, OR IC, PV01 CANNOT BE CODED '1' (PERSON). IF PV01 IS CODED '1' (PERSON) FOR AN HS, ER, OP, OR IC EVENT, DISPLAY THE FOLLOWING MESSAGE: 'A FACILITY MUST BE ASSOCIATED WITH [EV] TYPE. VERIFY PROVIDER AND RE-ENTER.'
----------------------------------------------------

top
1997
Survey form view entire document:  text  image
PV01
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV]
[[What is the name of the person or place that provided health care to (PERSON)?]]
INTERVIEWER: IS THE PROVIDER [ASSOCIATED WITH THIS EVENT] A PERSON OR A FACILITY (INCLUDING GROUP PRACTICES AND HMOs)?
PERSON ................................. 1
FACILITY ............................... 2 [BOX_01]
PRESS F1 FOR DEFINITION OF PERSON/FACILITY.
----------------------------------------------------
DISPLAY '[What is ... (PERSON)?]' AND 'ASSOCIATED WITH THIS EVENT' IF THE PROVIDER ROSTER (PV) SECTION WAS NOT CALLED FROM THE ACCESS TO CARE (AC) SECTION. IF THE PV SECTION WAS CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON), SET PROVIDER TYPE TO 'PERSON-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (FACILITY), SET PROVIDER TYPE TO 'FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND NO PROVIDERS THAT ARE TYPE 'PERSON-TYPE-PROVDER' ON RU-MEDICAL-PROVIDERS-ROSTER, GO TO PV04
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND AT LEAST ONE PROVIDER THAT IS TYPE 'PERSON-TYPE-PROVIDER' ON RU-MEDICAL-PROVIDERS-ROSTER, CONTINUE WITH PV02
----------------------------------------------------
----------------------------------------------------
EDIT: IF EVENT TYPE IS HS, ER, OP, OR IC, PV01 CANNOT BE CODED '1' (PERSON). IF PV01 IS CODED '1' (PERSON) FOR AN HS, ER, OP, OR IC EVENT, DISPLAY THE FOLLOWING MESSAGE: 'A FACILITY MUST BE ASSOCIATED WITH [EV] TYPE. VERIFY PROVIDER AND RE-ENTER.'
----------------------------------------------------
PV03
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV]
Is the address of (READ NAME AND ADDRESS OF PROVIDER BELOW)...
[PERSON-TYPE-PROVIDER NAME SELECTED AT PV02]
[FACILITY-PROVIDER W/ PERSON-TYPE-PROVIDER.]
[PERSON-TYPE-PROVIDER STREET ADDRESS LINE1.]
[PERSON-TYPE-PROVIDER STREET ADDRESS LINE2.]
ADDRESS [AND FACILITY NAME] CORRECT ...... 1 [BOX_02]
ADD NEW ADDRESS FOR PROVIDER ........... 2 [PV06]
ADD NEW/DIFFERENT FACILITY FOR PROVIDER ............................. 3 [BOX_01]
ABOVE PROVIDER NAME/ADDRESS [OR FACILITY NAME] NEEDS SPELLING OR MINOR CORRECTION .................. 4 [PV07]
SELECTED WRONG PROVIDER/ADDRESS ........ 5
REF ................................... -7 [BOX_02]
DK .................................... -8 [BOX_02]
[Code One]
----------------------------------------------------
FOR: [PERSON-TYPE-PROVIDER NAME SELECTED AT PV02], DISPLAY THE PERSON-TYPE-PROVIDER NAME SELECTED AT PV02.
FOR: [FACILITY-PROVIDER W/ PERSON-TYPE-PROVIDER.], DISPLAY THE FACILITY-PROVIDER NAME ASSOCIATED WITH THE PERSON-TYPE-PROVIDER SELECTED AT PV02. IF NO FACILITY-PROVIDER NAME ASSOCIATED WITH THIS PERSON-TYPE-PROVIDER, USE A NULL DISPLAY.
FOR: [PERSON-TYPE-PROVIDER STREET ADDRESS LINE1.] AND [PERSON-TYPE-PROVIDER STREET ADDRESS LINE2.], DISPLAY LINES 1 AND 2 OF THE PERSON-TYPE-PROVIDER'S ADDRESS FOR THE PERSON-TYPE-PROVIDER SELECTED AT PV02.

DISPLAY 'AND FACILITY NAME' AND 'OR FACILITY NAME' IF FACILITY-PROVIDER NAME ASSOCIATED WITH THE PERSON-TYPE-PROVIDER SELECTED AT PV02. IF NO FACILITY-PROVIDER NAME ASSOCIATED WITH THIS PERSON-TYPE-PROVIDER, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (SELECTED WRONG PROVIDER/ADDRESS), CAPI REDISPLAYS PV02 TO ALLOW INTERVIEWER TO SELECT CORRECT PROVIDER.
----------------------------------------------------
PV05
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EV]
Is (PROVIDER) in a group practice, that is, do other doctors practice at the same office (or are part of an HMO)?
YES .................................... 1 [BOX_01]
NO ..................................... 2
REF ................................... -7
DK .................................... -8
----------------------------------------------------
IF CODED '1' (YES), FLAG PERSON-TYPE-PROVIDER AS 'PERSON-IN-FACILITY-PROVIDER'.
----------------------------------------------------
PV10
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EV]
ENTER [NEW] [NAME AND] ADDRESS OF ([PROVIDER/FACILITY]).
ENTER [NAME AND] STREET ADDRESS AND VERIFY SPELLING. IF ([PROVIDER/FACILITY]) HAS MORE THAN ONE LOCATION, RECORD LOCATION PERSON VISITED.
FACILITY_NAME (PV10_01): [_____________]
FACILITY_STR1 (PV10_02): [_____________]
FACILITY_STR2 (PV10_03): [_____________]
----------------------------------------------------
DISPLAY 'NEW' IF PV09 IS CODED '2' (ADD NEW ADDRESS FOR FACILITY). OTHERWISE, USE A NULL DISPLAY. DISPLAY 'PROVIDER' IF PV01 IS CODED '2' (FACILITY). DISPLAY 'FACILITY' IF PV01 IS CODED '1' (PERSON). DISPLAY 'NAME AND' IF 'NONE OF THE ABOVE' WAS SELECTED AT PV08 OR PV08 WAS NOT ASKED.
IF 'NONE OF THE ABOVE' WAS SELECTED AT PV08 OR PV08 WAS NOT ASKED, THE CONTEXT HEADER WILL NOT DISPLAY THE NAME OF THE MEDICAL CARE PROVIDER.
THE CONTEXT HEADER WILL ONLY HAVE THE NAME OF THE PROVIDER(S) ASSOCIATED WITH THE EVENT IF PV09 WAS CODED '2' (ADD NEW ADDRESS FOR FACILITY).
----------------------------------------------------
----------------------------------------------------
CODES '-7' (REF) AND '-8' (DK) ARE ALLOWED ON PV10_02 AND PV10_03 ONLY.
----------------------------------------------------
----------------------------------------------------
IF PV09 IS CODED '2' (ADD NEW ADDRESS FOR FACILITY), PV10 WILL NOT COLLECT THE FACILITY NAME.
----------------------------------------------------
----------------------------------------------------
IF FACILITY-PROVIDER NOT SELECTED AT PV08 (I.E., PV08 WAS NOT ASKED OR 'NONE OF THE ABOVE' WAS SELECTED), WRITE NAME AND ADDRESS ENTERED ABOVE TO FACILITY-PROVIDER NAME COLUMN AND ADDRESS COLUMN OF THE RU-MEDICAL-PROVIDERS-ROSTER.

IF FACILITY-PROVIDER SELECTED AT PV08 AND PV09 WAS CODED '2' (ADD NEW ADDRESS FOR FACILITY), WRITE ANOTHER RECORD FOR THE FACILITY-PROVIDER TO THE RU-MEDICAL-PROVIDERS-ROSTER AND ASSOCIATE ADDRESS WITH THAT NEW PROVIDER RECORD.

IF PV01 IS CODED '1' (PERSON), LINK THE FACILITY TO THE PERSON-TYPE-PROVIDER FLAGGED AS 'PERSON-IN-FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
GO TO BOX_02
----------------------------------------------------

top
1996
Survey form view entire document:  text  image
PV01
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV]
[[What is the name of the person or place that provided health care to (PERSON)?]]
INTERVIEWER: IS THE PROVIDER [ASSOCIATED WITH THIS EVENT] A PERSON OR A FACILITY (INCLUDING GROUP PRACTICES AND HMOs)?
PERSON ................................. 1
FACILITY ............................... 2 [BOX_01]
PRESS F1 FOR DEFINITION OF PERSON/FACILITY.
----------------------------------------------------
DISPLAY '[What is ... (PERSON)?]' AND 'ASSOCIATED WITH THIS EVENT' IF THE PROVIDER ROSTER (PV) SECTION WAS NOT CALLED FROM THE ACCESS TO CARE (AC) SECTION. IF THE PV SECTION WAS CALLED FROM THE AC SECTION, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON), SET PROVIDER TYPE TO 'PERSON-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (FACILITY), SET PROVIDER TYPE TO 'FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND NO PROVIDERS THAT ARE TYPE 'PERSON-TYPE-PROVDER' ON RU-MEDICAL-PROVIDERS-ROSTER, GO TO PV04
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (PERSON) AND AT LEAST ONE PROVIDER THAT IS TYPE 'PERSON-TYPE-PROVIDER' ON RU-MEDICAL-PROVIDERS-ROSTER, CONTINUE WITH PV02
----------------------------------------------------
----------------------------------------------------
EDIT: IF EVENT TYPE IS HS, ER, OP, OR IC, PV01 CANNOT BE CODED '1' (PERSON). IF PV01 IS CODED '1' (PERSON) FOR AN HS, ER, OP, OR IC EVENT, DISPLAY THE FOLLOWING MESSAGE: 'A FACILITY MUST BE ASSOCIATED WITH [EV] TYPE. VERIFY PROVIDER AND RE-ENTER.'
----------------------------------------------------
PV03
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [EV]
Is the address of (READ NAME AND ADDRESS OF PROVIDER BELOW)...
[PERSON-TYPE-PROVIDER NAME SELECTED AT PV02]
[FACILITY-PROVIDER W/ PERSON-TYPE-PROVIDER.]
[PERSON-TYPE-PROVIDER STREET ADDRESS LINE1.]
[PERSON-TYPE-PROVIDER STREET ADDRESS LINE2.]
ADDRESS [AND FACILITY NAME] CORRECT ...... 1 [BOX_02]
ADD NEW ADDRESS FOR PROVIDER ........... 2 [PV06]
ADD NEW/DIFFERENT FACILITY FOR PROVIDER ............................. 3 [BOX_01]
ABOVE PROVIDER NAME/ADDRESS [OR FACILITY NAME] NEEDS SPELLING OR MINOR CORRECTION .................. 4 [PV07]
SELECTED WRONG PROVIDER/ADDRESS ........ 5
REF ................................... -7 [BOX_02]
DK .................................... -8 [BOX_02]
[Code One]
----------------------------------------------------
FOR: [PERSON-TYPE-PROVIDER NAME SELECTED AT PV02], DISPLAY THE PERSON-TYPE-PROVIDER NAME SELECTED AT PV02.
FOR: [FACILITY-PROVIDER W/ PERSON-TYPE-PROVIDER.], DISPLAY THE FACILITY-PROVIDER NAME ASSOCIATED WITH THE PERSON-TYPE-PROVIDER SELECTED AT PV02. IF NO FACILITY-PROVIDER NAME ASSOCIATED WITH THIS PERSON-TYPE-PROVIDER, USE A NULL DISPLAY.
FOR: [PERSON-TYPE-PROVIDER STREET ADDRESS LINE1.] AND [PERSON-TYPE-PROVIDER STREET ADDRESS LINE2.], DISPLAY LINES 1 AND 2 OF THE PERSON-TYPE-PROVIDER'S ADDRESS FOR THE PERSON-TYPE-PROVIDER SELECTED AT PV02.

DISPLAY 'AND FACILITY NAME' AND 'OR FACILITY NAME' IF FACILITY-PROVIDER NAME ASSOCIATED WITH THE PERSON-TYPE-PROVIDER SELECTED AT PV02. IF NO FACILITY-PROVIDER NAME ASSOCIATED WITH THIS PERSON-TYPE-PROVIDER, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF CODED '5' (SELECTED WRONG PROVIDER/ADDRESS), CAPI REDISPLAYS PV02 TO ALLOW INTERVIEWER TO SELECT CORRECT PROVIDER.
----------------------------------------------------
PV05
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EV]
Is (PROVIDER) in a group practice, that is, do other doctors practice at the same office (or are part of an HMO)?
YES .................................... 1 [BOX_01]
NO ..................................... 2
REF ................................... -7
DK .................................... -8
----------------------------------------------------
IF CODED '1' (YES), FLAG PERSON-TYPE-PROVIDER AS 'PERSON-IN-FACILITY-PROVIDER'.
----------------------------------------------------
PV10
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EV]
ENTER [NEW] [NAME AND] ADDRESS OF ([PROVIDER/FACILITY]).
ENTER [NAME AND] STREET ADDRESS AND VERIFY SPELLING. IF ([PROVIDER/FACILITY]) HAS MORE THAN ONE LOCATION, RECORD LOCATION PERSON VISITED.
FACILITY_NAME (PV10_01): [_____________]
FACILITY_STR1 (PV10_02): [_____________]
FACILITY_STR2 (PV10_03): [_____________]
----------------------------------------------------
DISPLAY 'NEW' IF PV09 IS CODED '2' (ADD NEW ADDRESS FOR FACILITY). OTHERWISE, USE A NULL DISPLAY. DISPLAY 'PROVIDER' IF PV01 IS CODED '2' (FACILITY). DISPLAY 'FACILITY' IF PV01 IS CODED '1' (PERSON). DISPLAY 'NAME AND' IF 'NONE OF THE ABOVE' WAS SELECTED AT PV08 OR PV08 WAS NOT ASKED.
IF 'NONE OF THE ABOVE' WAS SELECTED AT PV08 OR PV08 WAS NOT ASKED, THE CONTEXT HEADER WILL NOT DISPLAY THE NAME OF THE MEDICAL CARE PROVIDER.
THE CONTEXT HEADER WILL ONLY HAVE THE NAME OF THE PROVIDER(S) ASSOCIATED WITH THE EVENT IF PV09 WAS CODED '2' (ADD NEW ADDRESS FOR FACILITY).
----------------------------------------------------
----------------------------------------------------
CODES '-7' (REF) AND '-8' (DK) ARE ALLOWED ON PV10_02 AND PV10_03 ONLY.
----------------------------------------------------
----------------------------------------------------
IF PV09 IS CODED '2' (ADD NEW ADDRESS FOR FACILITY), PV10 WILL NOT COLLECT THE FACILITY NAME.
----------------------------------------------------
----------------------------------------------------
IF FACILITY-PROVIDER NOT SELECTED AT PV08 (I.E., PV08 WAS NOT ASKED OR 'NONE OF THE ABOVE' WAS SELECTED), WRITE NAME AND ADDRESS ENTERED ABOVE TO FACILITY-PROVIDER NAME COLUMN AND ADDRESS COLUMN OF THE RU-MEDICAL-PROVIDERS-ROSTER.

IF FACILITY-PROVIDER SELECTED AT PV08 AND PV09 WAS CODED '2' (ADD NEW ADDRESS FOR FACILITY), WRITE ANOTHER RECORD FOR THE FACILITY-PROVIDER TO THE RU-MEDICAL-PROVIDERS-ROSTER AND ASSOCIATE ADDRESS WITH THAT NEW PROVIDER RECORD.

IF PV01 IS CODED '1' (PERSON), LINK THE FACILITY TO THE PERSON-TYPE-PROVIDER FLAGGED AS 'PERSON-IN-FACILITY-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
GO TO BOX_02
----------------------------------------------------