[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does [someone at] (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8
----------------------------------------------------
DISPLAY ?someone at? IF USC PROVIDER BEING LOOPED ON IS FLAGGED AS ?FACILITY-TYPE-PROVIDER?.
OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------

[NAME OF MEDICAL CARE PROVIDER......]
Does [someone at] (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8
----------------------------------------------------
DISPLAY 'someone at' IF USC PROVIDER BEING LOOPED ON IS FLAGGED AS 'FACILITY-TYPE-PROVIDER'.
OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8

[NAME OF MEDICAL CARE PROVIDER......]
Does (PROVIDER) usually ask about prescription medications and treatments other doctors may give them?

YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8