Survey Text

1978
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1978
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D
1 [] 17-64 (1)
2 [] Other (NP)

1a. During the past 12 months, has -- given or sold any blood to a blood bank, a hospital, the Red Cross, or anywhere else?

1 [] Y
2 [] N (2)

b. During the past 12 months, how many times has -- given or sold blood? ____

Hand Card B

For each time reported in 1b, ask:

c. Which of the reasons listed on this card best describes why -- gave blood (the last time/the time before that, etc.)? Please give me the number of the reason.

CARD B
1. Sold blood.
2. Replaced blood used by a relative or friend.
3. Unpaid donation to a blood bank to assure free blood for this family in the future.
4. Other unpaid blood donation which was NOT for replacement and did NOT assure free blood for this family in the future.
5. Some other reason -- Specify

[The response indicates 4 rows listed in descending order from most recent to the least recent. The response choices are the same and only one row is indicated here.]

[Rows 1-4]
(Last time)

[] 1 (3)
[] 2 (3)
[] 3 (3)
[] 4 (3)
[] 5 (Specify) ____ (3)

2a. Has -- EVER given or sold blood to a blood bank, a hospital, the Red Cross or anywhere else?

1 [] Y
2 [] N (4)
9 [] DK (4)

b. About how long has it been since -- LAST gave or sold blood?

(Was it more than 5 years or less than 5 years?)
(Was it more than 10 years or less than 10 years?)

Years ____
99 [] DK

3. About how many times has -- EVER given or sold blood?

Times ____
99 [] DK

4. Has -- EVER been asked in person, either face-to-face or over the telephone, to give or sell blood?

1 [] Y
2 [] N
9 [] DK
R1
Q's 1-4

For persons aged 17-64, show who responded for (or was present during the asking of) Questions 1-4.

If person responded for self, show whether entirely or partly.

1 [] Responded for self-entirely
2 [] Responded for self-partly
Person ____ was respondent