Survey Text

2017 2013 2009 2005
2016 2012 2008 2004
2015 2011 2007 2003
2014 2010 2006 2002
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2017
Survey form view entire document:  text  image
AC22
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC22_01 a. New health problems? ( )
AC22_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC22_03 c. Referrals to other health professionals when needed? ( )
AC22_04 d. Ongoing health problems? ( )
PRESS F1 FOR DEFINITION OF PREVENTIVE HEALTH CARE AND REFERRAL.
----------------------------------------------------
DISPLAY 'person' IF THE USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'PERSON-TYPE-PROVIDER' OR 'PERSON-IN-FACILITY-PROVIDER'. DISPLAY 'place' IF USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'FACILITY-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
ALLOW '-7' (REFUSED) AND '-8' (DON'T KNOW) ON ALL FORM ITEMS.
----------------------------------------------------

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2016
Survey form view entire document:  text  image
AC22
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC22_01 a. New health problems? ( )
AC22_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC22_03 c. Referrals to other health professionals when needed? ( )
AC22_04 d. Ongoing health problems? ( )
PRESS F1 FOR DEFINITION OF PREVENTIVE HEALTH CARE AND REFERRAL.
----------------------------------------------------
DISPLAY 'person' IF THE USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'PERSON-TYPE-PROVIDER' OR 'PERSON-IN-FACILITY-PROVIDER'. DISPLAY 'place' IF USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'FACILITY-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
ALLOW '-7' (REFUSED) AND '-8' (DON'T KNOW) ON ALL FORM ITEMS.
----------------------------------------------------

top
2015
Survey form view entire document:  text  image
AC22
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC22_01 a. New health problems? ( )
AC22_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC22_03 c. Referrals to other health professionals when needed? ( )
AC22_04 d. Ongoing health problems? ( )
PRESS F1 FOR DEFINITION OF PREVENTIVE HEALTH CARE AND REFERRAL.
----------------------------------------------------
DISPLAY 'person' IF THE USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'PERSON-TYPE-PROVIDER' OR 'PERSON-IN-FACILITY-PROVIDER'. DISPLAY 'place' IF USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'FACILITY-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
ALLOW '-7' (REFUSED) AND '-8' (DON'T KNOW) ON ALL FORM ITEMS.
----------------------------------------------------

top
2014
Survey form view entire document:  text  image
AC22
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC22_01 a. New health problems? ( )
AC22_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC22_03 c. Referrals to other health professionals when needed? ( )
AC22_04 d. Ongoing health problems? ( )
PRESS F1 FOR DEFINITION OF PREVENTIVE HEALTH CARE AND REFERRAL.
----------------------------------------------------
DISPLAY 'person' IF THE USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'PERSON-TYPE-PROVIDER' OR 'PERSON-IN-FACILITY-PROVIDER'. DISPLAY 'place' IF USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'FACILITY-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
ALLOW '-7' (REFUSED) AND '-8' (DON'T KNOW) ON ALL FORM ITEMS.
----------------------------------------------------

top
2013
Survey form view entire document:  text  image
AC22
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC22_01 a. New health problems? ( )
AC22_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC22_03 c. Referrals to other health professionals when needed? ( )
AC22_04 d. Ongoing health problems? ( )
PRESS F1 FOR DEFINITION OF PREVENTIVE HEALTH CARE AND REFERRAL.
----------------------------------------------------
DISPLAY 'person' IF THE USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'PERSON-TYPE-PROVIDER' OR 'PERSON-IN-FACILITY-PROVIDER'. DISPLAY 'place' IF USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'FACILITY-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
ALLOW '-7' (REFUSED) AND '-8' (DON'T KNOW) ON ALL FORM ITEMS.
----------------------------------------------------

top
2012
Survey form view entire document:  text  image
AC22
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC22_01 a. New health problems? ( )
AC22_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC22_03 c. Referrals to other health professionals when needed? ( )
AC22_04 d. Ongoing health problems? ( )
PRESS F1 FOR DEFINITION OF PREVENTIVE HEALTH CARE AND REFERRAL.
----------------------------------------------------
DISPLAY 'person' IF THE USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'PERSON-TYPE-PROVIDER' OR 'PERSON-IN-FACILITY-PROVIDER'. DISPLAY 'place' IF USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'FACILITY-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
ALLOW '-7' (REFUSED) AND '-8' (DON'T KNOW) ON ALL FORM ITEMS.
----------------------------------------------------

top
2011
Survey form view entire document:  text  image
AC22
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC22_01 a. New health problems? ( )
AC22_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC22_03 c. Referrals to other health professionals when needed? ( )
AC22_04 d. Ongoing health problems? ( )
PRESS F1 FOR DEFINITION OF PREVENTIVE HEALTH CARE AND REFERRAL.
----------------------------------------------------
DISPLAY 'person' IF THE USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'PERSON-TYPE-PROVIDER' OR 'PERSON-IN-FACILITY-PROVIDER'. DISPLAY 'place' IF USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'FACILITY-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
ALLOW '-7' (REFUSED) AND '-8' (DON'T KNOW) ON ALL FORM ITEMS.
----------------------------------------------------

top
2010
Survey form view entire document:  text  image
AC22
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC22_01 a. New health problems? ( )
AC22_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC22_03 c. Referrals to other health professionals when needed? ( )
AC22_04 d. Ongoing health problems? ( )
PRESS F1 FOR DEFINITION OF PREVENTIVE HEALTH CARE AND REFERRAL.
----------------------------------------------------
DISPLAY 'person' IF THE USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'PERSON-TYPE-PROVIDER' OR 'PERSON-IN-FACILITY-PROVIDER'. DISPLAY 'place' IF USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'FACILITY-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
ALLOW '-7' (REFUSED) AND '-8' (DON'T KNOW) ON ALL FORM ITEMS.
----------------------------------------------------

top
2009
Survey form view entire document:  text  image
AC22
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC22_01 a. New health problems? ( )
AC22_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC22_03 c. Referrals to other health professionals when needed? ( )
AC22_04 d. Ongoing health problems? ( )
PRESS F1 FOR DEFINITION OF PREVENTIVE HEALTH CARE AND REFERRAL.
----------------------------------------------------
DISPLAY 'person' IF THE USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'PERSON-TYPE-PROVIDER' OR 'PERSON-IN-FACILITY-PROVIDER'. DISPLAY 'place' IF USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'FACILITY-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
ALLOW '-7' (REFUSED) AND '-8' (DON'T KNOW) ON ALL FORM ITEMS.
----------------------------------------------------

top
2008
Survey form view entire document:  text  image
AC22
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC22_01 a. New health problems? ( )
AC22_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC22_03 c. Referrals to other health professionals when needed? ( )
AC22_04 d. Ongoing health problems? ( )
PRESS F1 FOR DEFINITION OF PREVENTIVE HEALTH CARE AND REFERRAL.
----------------------------------------------------
DISPLAY 'person' IF THE USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'PERSON-TYPE-PROVIDER' OR 'PERSON-IN-FACILITY-PROVIDER'. DISPLAY 'place' IF USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'FACILITY-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
ALLOW '-7' (REFUSED) AND '-8' (DON'T KNOW) ON ALL FORM ITEMS.
----------------------------------------------------

top
2007
Survey form view entire document:  text  image
AC22
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC22_01 a. New health problems? ( )
AC22_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC22_03 c. Referrals to other health professionals when needed? ( )
AC22_04 d. Ongoing health problems? ( )
PRESS F1 FOR DEFINITION OF PREVENTIVE HEALTH CARE AND REFERRAL.
----------------------------------------------------
DISPLAY 'person' IF THE USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'PERSON-TYPE-PROVIDER' OR 'PERSON-IN-FACILITY-PROVIDER'. DISPLAY 'place' IF USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'FACILITY-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
ALLOW '-7' (REFUSED) AND '-8' (DON'T KNOW) ON ALL FORM ITEMS.
----------------------------------------------------

top
2006
Survey form view entire document:  text  image
AC22
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC22_01 a. New health problems? ( )
AC22_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC22_03 c. Referrals to other health professionals when needed? ( )
AC22_04 d. Ongoing health problems? ( )
PRESS F1 FOR DEFINITION OF PREVENTIVE HEALTH CARE AND REFERRAL.
----------------------------------------------------
DISPLAY 'person' IF THE USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'PERSON-TYPE-PROVIDER' OR 'PERSON-IN-FACILITY-PROVIDER'. DISPLAY 'place' IF USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'FACILITY-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
ALLOW '-7' (REFUSED) AND '-8' (DON'T KNOW) ON ALL FORM ITEMS.
----------------------------------------------------

top
2005
Survey form view entire document:  text  image
AC22
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC22_01 a. New health problems? ( )
AC22_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC22_03 c. Referrals to other health professionals when needed? ( )
AC22_04 d. Ongoing health problems? ( )
PRESS F1 FOR DEFINITION OF PREVENTIVE HEALTH CARE AND REFERRAL.
----------------------------------------------------
DISPLAY 'person' IF THE USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'PERSON-TYPE-PROVIDER' OR 'PERSON-IN-FACILITY-PROVIDER'. DISPLAY 'place' IF USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'FACILITY-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
ALLOW '-7' (REFUSED) AND '-8' (DON'T KNOW) ON ALL FORM ITEMS.
----------------------------------------------------

top
2004
Survey form view entire document:  text  image
AC22
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC22_01 a. New health problems? ( )
AC22_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC22_03 c. Referrals to other health professionals when needed? ( )
AC22_04 d. Ongoing health problems? ( )
PRESS F1 FOR DEFINITION OF PREVENTIVE HEALTH CARE AND REFERRAL.
----------------------------------------------------
DISPLAY 'person' IF THE USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'PERSON-TYPE-PROVIDER' OR 'PERSON-IN-FACILITY-PROVIDER'. DISPLAY 'place' IF USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'FACILITY-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
ALLOW '-7' (REFUSED) AND '-8' (DON'T KNOW) ON ALL FORM ITEMS.
----------------------------------------------------

top
2003
Survey form view entire document:  text  image
AC22
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC22_01 a. New health problems? ( )
AC22_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC22_03 c. Referrals to other health professionals when needed? ( )
AC22_04 d. Ongoing health problems? ( )
PRESS F1 FOR DEFINITION OF PREVENTIVE HEALTH CARE AND REFERRAL.
----------------------------------------------------
DISPLAY 'person' IF THE USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'PERSON-TYPE-PROVIDER' OR 'PERSON-IN-FACILITY-PROVIDER'. DISPLAY 'place' IF USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'FACILITY-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
ALLOW '-7' (REFUSED) AND '-8' (DON'T KNOW) ON ALL FORM ITEMS.
----------------------------------------------------

top
2002
Survey form view entire document:  text  image
AC22
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC22_01 a. New health problems? ( )
AC22_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC22_03 c. Referrals to other health professionals when needed? ( )
AC22_04 d. Ongoing health problems? ( )
PRESS F1 FOR DEFINITION OF PREVENTIVE HEALTH CARE AND REFERRAL.
----------------------------------------------------
DISPLAY 'person' IF THE USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'PERSON-TYPE-PROVIDER' OR 'PERSON-IN-FACILITY-PROVIDER'. DISPLAY 'place' IF USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'FACILITY-TYPE-PROVIDER'.
----------------------------------------------------
----------------------------------------------------
ALLOW '-7' (REFUSED) AND '-8' (DON'T KNOW) ON ALL FORM ITEMS.
----------------------------------------------------