Survey Text

2016
2012
top
2016
Survey form view entire document:  text  image
Question ID: CBL.030_00.000

Instrument Variable Name: CBALFALL
Questionnaire File Name: Sample Child
Question Text:
*Read if necessary.
DURING THE PAST 12 MONTHS, has [fill1: S.C. name] been bothered by episodes of any of the following dizziness or balance problems...
frequent, unexpected falls?
*If asked, specify: if falls EVER happened more often than once a week.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text: Sample children 3+
Skip Instructions:
(1,2,R,D) [goto CBALPASS]

top
2012
Survey form view entire document:  text  image
Question ID:: CBL.030_00.000

Instrument Variable Name:: CBALFALL
QuestionText:
*Read if necessary. DURING THE PAST 12 MONTHS, has {fill1: S.C. name} been bothered by episodes of any of the following dizziness or balance problems? Frequent falls?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: Sample children 3+
SkipInstructions:
(1,2,R,D) [goto CBALPASS]