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1990

Survey form view entire document: text image

Hand Card M1. Read all answer categories if telephone interview.
Card M1

1. Already installed/no payment
2. Gift
3. Self or family
4. Private health insurance
5. Medicare
6. Medicaid
7. Rehabilitation program
8. Employer
9. School system
10. VA program
11. Other private source
12. Other public source

c. Who (else) paid for the (device) -- uses at (work/(or) school)?
Mark all that apply.

01[] Already installed/no payment
02[] Gift
03[] Self or family
04[] Private health insurance
05[] Medicare
06[] Medicaid
07[] Rehabilitation program
08[] Employer
09[] School system
10[] VA program
11[] Other private source
12[] Other public source
99[] DK

Survey form view entire document: text image

Hand Card M1. Read all answer categories if telephone interview.
Card M1

1. Already installed/no payment
2. Gift
3. Self or family
4. Private health insurance
5. Medicare
6. Medicaid
7. Rehabilitation program
8. Employer
9. School system
10. VA program
11. Other private source
12. Other public source

c. Who (else) paid for the (device) -- uses at (work/(or) school)?
Mark all that apply.

01[] Already installed/no payment
02[] Gift
03[] Self or family
04[] Private health insurance
05[] Medicare
06[] Medicaid
07[] Rehabilitation program
08[] Employer
09[] School system
10[] VA program
11[] Other private source
12[] Other public source
99[] DK

Survey form view entire document: text image

Hand Card M1. Read all answer categories if telephone interview.
Card M1

1. Already installed/no payment
2. Gift
3. Self or family
4. Private health insurance
5. Medicare
6. Medicaid
7. Rehabilitation program
8. Employer
9. School system
10. VA program
11. Other private source
12. Other public source

c. Who (else) paid for the (device) -- uses at (work/(or) school)?
Mark all that apply.

01[] Already installed/no payment
02[] Gift
03[] Self or family
04[] Private health insurance
05[] Medicare
06[] Medicaid
07[] Rehabilitation program
08[] Employer
09[] School system
10[] VA program
11[] Other private source
12[] Other public source
99[] DK

Survey form view entire document: text image

Hand Card M1. Read all answer categories if telephone interview.
Card M1

1. Already installed/no payment
2. Gift
3. Self or family
4. Private health insurance
5. Medicare
6. Medicaid
7. Rehabilitation program
8. Employer
9. School system
10. VA program
11. Other private source
12. Other public source

c. Who (else) paid for the (device) -- uses at (work/(or) school)?
Mark all that apply.

01[] Already installed/no payment
02[] Gift
03[] Self or family
04[] Private health insurance
05[] Medicare
06[] Medicaid
07[] Rehabilitation program
08[] Employer
09[] School system
10[] VA program
11[] Other private source
12[] Other public source
99[] DK

Survey form view entire document: text image

Hand Card M1. Read all answer categories if telephone interview.
Card M1

1. Already installed/no payment
2. Gift
3. Self or family
4. Private health insurance
5. Medicare
6. Medicaid
7. Rehabilitation program
8. Employer
9. School system
10. VA program
11. Other private source
12. Other public source

c. Who (else) paid for the (device) -- uses at (work/(or) school)?
Mark all that apply.

01[] Already installed/no payment
02[] Gift
03[] Self or family
04[] Private health insurance
05[] Medicare
06[] Medicaid
07[] Rehabilitation program
08[] Employer
09[] School system
10[] VA program
11[] Other private source
12[] Other public source
99[] DK

Survey form view entire document: text image

Hand Card M1. Read all answer categories if telephone interview.
Card M1

1. Already installed/no payment
2. Gift
3. Self or family
4. Private health insurance
5. Medicare
6. Medicaid
7. Rehabilitation program
8. Employer
9. School system
10. VA program
11. Other private source
12. Other public source

c. Who (else) paid for the (device) -- uses at (work/(or) school)?
Mark all that apply.

01[] Already installed/no payment
02[] Gift
03[] Self or family
04[] Private health insurance
05[] Medicare
06[] Medicaid
07[] Rehabilitation program
08[] Employer
09[] School system
10[] VA program
11[] Other private source
12[] Other public source
99[] DK

Survey form view entire document: text image

Hand Card M1. Read all answer categories if telephone interview.
Card M1

1. Already installed/no payment
2. Gift
3. Self or family
4. Private health insurance
5. Medicare
6. Medicaid
7. Rehabilitation program
8. Employer
9. School system
10. VA program
11. Other private source
12. Other public source

c. Who (else) paid for the (device) -- uses at (work/(or) school)?
Mark all that apply.

01[] Already installed/no payment
02[] Gift
03[] Self or family
04[] Private health insurance
05[] Medicare
06[] Medicaid
07[] Rehabilitation program
08[] Employer
09[] School system
10[] VA program
11[] Other private source
12[] Other public source
99[] DK

Survey form view entire document: text image

Hand Card M1. Read all answer categories if telephone interview.
Card M1

1. Already installed/no payment
2. Gift
3. Self or family
4. Private health insurance
5. Medicare
6. Medicaid
7. Rehabilitation program
8. Employer
9. School system
10. VA program
11. Other private source
12. Other public source

c. Who (else) paid for the (device) -- uses at (work/(or) school)?
Mark all that apply.

01[] Already installed/no payment
02[] Gift
03[] Self or family
04[] Private health insurance
05[] Medicare
06[] Medicaid
07[] Rehabilitation program
08[] Employer
09[] School system
10[] VA program
11[] Other private source
12[] Other public source
99[] DK

Survey form view entire document: text image

Hand Card M1. Read all answer categories if telephone interview.
Card M1

1. Already installed/no payment
2. Gift
3. Self or family
4. Private health insurance
5. Medicare
6. Medicaid
7. Rehabilitation program
8. Employer
9. School system
10. VA program
11. Other private source
12. Other public source

c. Who (else) paid for the (device) -- uses at (work/(or) school)?
Mark all that apply.

01[] Already installed/no payment
02[] Gift
03[] Self or family
04[] Private health insurance
05[] Medicare
06[] Medicaid
07[] Rehabilitation program
08[] Employer
09[] School system
10[] VA program
11[] Other private source
12[] Other public source
99[] DK

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