Survey Text

2007
2006
2005
2004
2003
2002
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2007
Survey form view entire document:  text  image
AC10
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......]
(Do/Does) (PERSON) usually see a particular provider at (PROVIDER)?
YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8
----------------------------------------------------
NOTE: FOR QUESTIONS AC10 ? 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.
----------------------------------------------------
----------------------------------------------------
IF AC11 WAS NOT ALREADY ASKED FOR THIS USC PROVIDER IN AN EARLIER LOOP, CONTINUE WITH AC11
----------------------------------------------------
----------------------------------------------------
OTHERWISE, GO TO AC12
----------------------------------------------------

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2006
Survey form view entire document:  text  image
AC10
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......]
(Do/Does) (PERSON) usually see a particular provider at (PROVIDER)?
YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8
----------------------------------------------------
NOTE: FOR QUESTIONS AC10 ? 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.
----------------------------------------------------
----------------------------------------------------
IF AC11 WAS NOT ALREADY ASKED FOR THIS USC PROVIDER IN AN EARLIER LOOP, CONTINUE WITH AC11
----------------------------------------------------
----------------------------------------------------
OTHERWISE, GO TO AC12
----------------------------------------------------

top
2005
Survey form view entire document:  text  image
AC10
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......]
(Do/Does) (PERSON) usually see a particular provider at (PROVIDER)?
YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8
----------------------------------------------------
NOTE: FOR QUESTIONS AC10 ? 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.
----------------------------------------------------
----------------------------------------------------
IF AC11 WAS NOT ALREADY ASKED FOR THIS USC PROVIDER IN AN EARLIER LOOP, CONTINUE WITH AC11
----------------------------------------------------
----------------------------------------------------
OTHERWISE, GO TO AC12
----------------------------------------------------

top
2004
Survey form view entire document:  text  image
AC10
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......]
(Do/Does) (PERSON) usually see a particular provider at (PROVIDER)?
YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8
----------------------------------------------------
NOTE: FOR QUESTIONS AC10 ? 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.
----------------------------------------------------
----------------------------------------------------
IF AC11 WAS NOT ALREADY ASKED FOR THIS USC PROVIDER IN AN EARLIER LOOP, CONTINUE WITH AC11
----------------------------------------------------
----------------------------------------------------
OTHERWISE, GO TO AC12
----------------------------------------------------

top
2003
Survey form view entire document:  text  image
AC10
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......]
(Do/Does) (PERSON) usually see a particular provider at (PROVIDER)?
YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8
----------------------------------------------------
NOTE: FOR QUESTIONS AC10 ? 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.
----------------------------------------------------
----------------------------------------------------
IF AC11 WAS NOT ALREADY ASKED FOR THIS USC PROVIDER IN AN EARLIER LOOP, CONTINUE WITH AC11
----------------------------------------------------
----------------------------------------------------
OTHERWISE, GO TO AC12
----------------------------------------------------

top
2002
Survey form view entire document:  text  image
AC10
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......]
(Do/Does) (PERSON) usually see a particular provider at (PROVIDER)?
YES ..................................... 1
NO ...................................... 2
REF ..................................... -7
DK ...................................... -8
----------------------------------------------------
NOTE: FOR QUESTIONS AC10 ? 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.
----------------------------------------------------
----------------------------------------------------
IF AC11 WAS NOT ALREADY ASKED FOR THIS USC PROVIDER IN AN EARLIER LOOP, CONTINUE WITH AC11
----------------------------------------------------
----------------------------------------------------
OTHERWISE, GO TO AC12
----------------------------------------------------