DOCTOR VISITS PAGE
[There are two columns to fill in information for Doctor Visit (1) and Doctor Visit (2). The same information is included in both columns.]
DOCTOR VISIT (1) (2)
Earlier, you told me that -- had seen or talked to a doctor during the past 2 weeks.
7777  Last week
8888  Week before
b. Were there any other doctor visits for him during that period?
 N (As 3-5 for each visit)
3. Where did he see the doctor on the (date), at a clinic, hospital, doctor's office, or some other place?
If Hospital: Was it the out-patient clinic, or the emergency room?
If Clinic: Was it a hospital out-patient clinic, a company clinic, or some other kind of clinic?
01  Doctor's office (group practice or doctor's clinic)
10  Telephone
20  Hospital Out-Patient Clinic
30  Home
40  Hospital Emergency Room
50  Company or Industry Clinic
60  Other (Specify) ____
 Specialist - What kind of specialist is he? ____
3  General checkup (5b)
2  Pre or Postnatal care (Next DV)
4  Eye exam. (glasses) (Next DV)
5  Immunization (Next DV)
6  Other (Next DV)
b. Was this for any specific condition?
 N (Next DV)
Mark box or ask:
c. For what condition did -- visit the doctor on this date? ____