Survey Text

Survey form view entire document:  text  image

Ask 9 for the first 4 disorders recorded in Check Item 2.

[option to state up to 4 disorders [First Disorder - Fourth Disorder] in the original document not presented here; the same question format is asked of all the four disorders]

First Disorder in Check Item 2: ____
9a. When did a doctor or other health professional first give a diagnosis of (first disorder in Check Item 2) for --?

1[] Less than 1 year (9b)
2[] 1 yr., less than 5 yrs. (9b)
3[] 5 years or more (9b)
4[] Never (9d)
9[] DK