Survey Text

2017 2011 2005 1999
2016 2010 2004 1998
2015 2009 2003 1997
2014 2008 2002 1996
2013 2007 2001
2012 2006 2000
top
2017
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
2016
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
2015
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
2014
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
2013
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
2012
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
2011
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
2010
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
2009
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
2008
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
2007
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
2006
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
2005
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
2004
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
2003
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
2002
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
2001
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
2000
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
1999
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
1998
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
1997
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------

top
1996
Survey form view entire document:  text  image
AC14
====

[NAME OF MEDICAL CARE PROVIDER......]
Is (PROVIDER) the [person/place] they would go to for ...
YES = 1
NO = 2
AC14_01 a. New health problems? ( )
AC14_02 b. Preventive health care, such as general checkups, examinations, and immunizations? ( )
AC14_03 c. Referrals to other health professionals when needed? ( )
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.
----------------------------------------------------
----------------------------------------------------
IF AC06 WAS CODED '2' (HOSPITAL EMERGENCY ROOM) FOR THIS USC PROVIDER, GO TO AC19
----------------------------------------------------
----------------------------------------------------
OTHERWISE, CONTINUE WITH AC15
----------------------------------------------------