Doctor visits
Person approach
Record each date on which a doctor was visited in a separated question 2a of the doctor visits questions.
Earlier you told me that --had seen or talked to a doctor during the past 2 weeks
2a. On what dates during that 2 week period did --visit or talk to a doctor?
Day ______
Ask and record the answer to question 2b on the last set of Doctor visit questions for each person.
b. Were there any other doctor visits for -- during that period?
[] No-ask Q3-5 for each visit
3. Where did -- see the doctor on the (date)? Mark one
10[] Telephone
20[] Doctor's office
30[] Pre-paid insurance group
40[] Hospital out-patient clinic
50[] Hospital emergency room
70[] Health department
80[] Company or industry
90[] Other-specify ________
XX[] While inpatient in hospital-stop
4. How much was the doctor's bill for that visit (call)?
If bill not received, ask:
How much do you expect the doctor's bill to be for that visit (call)?
Cents ____
5. Is the doctor a general practitioner or a specialist?
[] Specialist
First visit: ____
Dum ____
Record each date on which a doctor was visited in a separate question 2a of the doctor visits questions.
2a. On what dates during that 2 week period did -- visit or talk to a doctor?
Day ____
b. Were there any other doctor visits for --during that period?
[] No-ask Q 3-5 for each visit
3. Where did -- see the doctor on the (Date)? Mark one.
10[] Telephone
20[] Doctor's office
30[] Pre-paid insurance group
40[] Hospital outpatient clinic
50[] Hospital emergency room
70[] Health department
80[] Company or industry
90[] Other-specify ________
XX[] While inpatient in hospital - stop
4. How much was the doctor's bill for that visit (call)?
If bill not received, ask:
How much do you expect the doctor's bill to be for that visit (call)?
Cents ____
5. Is the doctor a general practitioner or a specialist?
[] Specialist