FR: SHOW CARD A11

What was the MAIN REASON that you last went to the dentist?

1. Went in on own for check-up, examination, or cleaning
2. Was called in by the dentist for check-up, examination, or cleaning
3. Something was wrong, bothering, or hurting you
4. Went for treatment of a condition that dentist discovered at earlier check-up or examination
5. Other

(1) Went in on own for checkup, examination, or cleaning (AAU.135.030)
(2) Was called in by the dentist for checkup, examination, or cleaning (AAU.135.030)
(3) Something was wrong, bothering, or hurting you (AAU.135.030)
(4) Went for treatment of a condition that dentist discovered at earlier checkup or examination (AAU.135.030)
(5) Other (AAU.135.011)
(7) Refused (AAU.135.030)
(9) Don't know (AAU.135.030)

FR: SPECIFY OTHER REASON FOR DENTAL VISIT. THIS SHOULD BE A REASON THAT IS NOT ON THE DENTAL REASON LIST.

Dental reason: _______________

What was the main reason {S.C. name} last went to the dentist?

(1) Went in on own for check-up/exam
(2) Called in by the dentist for check-up/exam/cleaning
(3) Something wrong/hurting/bothering {S.C. name}
(4) Treated for condition dentist discovered earlier
(5) Other
(6) Check/adjust appliance/orthdontia
(7) Refused
(9) DK

1 [] Went in on own for check-up, examination or cleaning.
2 [] Was called in by the dentist for check-up, examination or cleaning.
3 [] Something was wrong, bothering or hurting --
4 [] Went for treatment of a condition that dentist discovered at earlier check-up or examination.
8 [] Other (Specify) ____
9 [] Don't know ____