2018 | 2012 | 2006 | 2000 |

2017 | 2011 | 2005 | 1999 |

2016 | 2010 | 2004 | 1998 |

2015 | 2009 | 2003 | |

2014 | 2008 | 2002 | |

2013 | 2007 | 2001 |

Survey form
view entire document:
text
image

Question ID: AHS.305_01.000

Instrument Variable Name: AHCL06N

QuestionText:

QuestionText:

1 of 2 How long have you had the (fill: other) injury that caused your limitation?

* Enter number for time with injury that caused your limitation.

* Enter '95'' for 95 or more.

* Enter "96" if since birth.

* Enter number for time with injury that caused your limitation.

* Enter '95'' for 95 or more.

* Enter "96" if since birth.

01-94 01-94

95 95+

96 Since birth

97 Refused

99 Don't know

95 95+

96 Since birth

97 Refused

99 Don't know

UniverseText: Sample adults 18+ who had difficulty due to an injury other than a fracture, bone, or joint injury

SkipInstructions:

SkipInstructions:

(1-95,D)[goto AHCL06T]

(R)[store "R" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(96)[store "6" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

Question ID: AHS.305_02.000
(R)[store "R" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(96)[store "6" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

Instrument Variable Name: AHCL06T

QuestionText:

QuestionText:

2 of 2 * Enter time period for time with (fill: other) injury.

1 Day(s)

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

UniverseText: Sample adults 18+ who answered 1-95, D for the "number" part of this 2-part question

SkipInstructions:

SkipInstructions:

(1- 4, R,D)[goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(6) goto ERR2_AHCL06T [if [AHCL06N = Number greater than person years old and AHCL06T= 4]] goto ERR1_AHCL06T

Hard Edit: ERR_AHCL06T

* Time with condition cannot be greater than age.

* Please correct.

(6) goto ERR2_AHCL06T [if [AHCL06N = Number greater than person years old and AHCL06T= 4]] goto ERR1_AHCL06T

Hard Edit: ERR_AHCL06T

* Time with condition cannot be greater than age.

* Please correct.

Survey form
view entire document:
text
image

Question ID: AHS.305_01.000

Instrument Variable Name: AHCL06N

QuestionText:

QuestionText:

1 of 2 How long have you had the (fill: other) injury that caused your limitation?

* Enter number for time with injury that caused your limitation.

* Enter '95'' for 95 or more.

* Enter "96" if since birth.

* Enter number for time with injury that caused your limitation.

* Enter '95'' for 95 or more.

* Enter "96" if since birth.

01-94 01-94

95 95+

96 Since birth

97 Refused

99 Don't know

95 95+

96 Since birth

97 Refused

99 Don't know

UniverseText: Sample adults 18+ who had difficulty due to an injury other than a fracture, bone, or joint injury

SkipInstructions:

SkipInstructions:

(1-95,D)[goto AHCL06T]

(R)[store "R" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(96)[store "6" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

Question ID: AHS.305_02.000
(R)[store "R" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(96)[store "6" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

Instrument Variable Name: AHCL06T

QuestionText:

QuestionText:

2 of 2 * Enter time period for time with (fill: other) injury.

1 Day(s)

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

UniverseText: Sample adults 18+ who answered 1-95, D for the "number" part of this 2-part question

SkipInstructions:

SkipInstructions:

(1- 4, R,D)[goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(6) goto ERR2_AHCL06T [if [AHCL06N = Number greater than person years old and AHCL06T= 4]] goto ERR1_AHCL06T

Hard Edit: ERR_AHCL06T

* Time with condition cannot be greater than age.

* Please correct.

(6) goto ERR2_AHCL06T [if [AHCL06N = Number greater than person years old and AHCL06T= 4]] goto ERR1_AHCL06T

Hard Edit: ERR_AHCL06T

* Time with condition cannot be greater than age.

* Please correct.

Survey form
view entire document:
text
image

Question ID: AHS.305_01.000

Instrument Variable Name: AHCL06N

QuestionText:

QuestionText:

1 of 2 How long have you had the (fill: other) injury that caused your limitation?

* Enter number for time with injury that caused your limitation.

* Enter '95'' for 95 or more.

* Enter "96" if since birth.

* Enter number for time with injury that caused your limitation.

* Enter '95'' for 95 or more.

* Enter "96" if since birth.

01-94 01-94

95 95+

96 Since birth

97 Refused

99 Don't know

95 95+

96 Since birth

97 Refused

99 Don't know

UniverseText: Sample adults 18+ who had difficulty due to an injury other than a fracture, bone, or joint injury

SkipInstructions:

SkipInstructions:

(1-95,D)[goto AHCL06T]

(R)[store "R" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(96)[store "6" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

Question ID: AHS.305_02.000
(R)[store "R" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(96)[store "6" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

Instrument Variable Name: AHCL06T

QuestionText:

QuestionText:

2 of 2 * Enter time period for time with (fill: other) injury.

1 Day(s)

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

UniverseText: Sample adults 18+ who answered 1-95, D for the "number" part of this 2-part question

SkipInstructions:

SkipInstructions:

(1- 4, R,D)[goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(6) goto ERR2_AHCL06T [if [AHCL06N = Number greater than person years old and AHCL06T= 4]] goto ERR1_AHCL06T

Hard Edit: ERR_AHCL06T

* Time with condition cannot be greater than age.

* Please correct.

(6) goto ERR2_AHCL06T [if [AHCL06N = Number greater than person years old and AHCL06T= 4]] goto ERR1_AHCL06T

Hard Edit: ERR_AHCL06T

* Time with condition cannot be greater than age.

* Please correct.

Survey form
view entire document:
text
image

Instrument Variable Name: AHCL06N

QuestionText:

QuestionText:

* Enter number for time with injury that caused your limitation.

* Enter '95'' for 95 or more.

* Enter "96" if since birth.

01-94 01-94

95 95+

96 Since birth

97 Refused

99 Don't know

95 95+

96 Since birth

97 Refused

99 Don't know

SkipInstructions:

(R)[store "R" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(96)[store "6" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

Instrument Variable Name: AHCL06T

QuestionText:

QuestionText:

2 of 2 * Enter time period for time with (fill: other) injury.

1 Day(s)

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

SkipInstructions:

(6) goto ERR2_AHCL06T [if [AHCL06N = Number greater than person years old and AHCL06T= 4]] goto ERR1_AHCL06T

Hard Edit: ERR_AHCL06T

* Time with condition cannot be greater than age.

* Please correct.

Survey form
view entire document:
text
image

Instrument Variable Name: AHCL06N

QuestionText:

QuestionText:

* Enter number for time with injury that caused your limitation.

* Enter '95'' for 95 or more.

* Enter "96" if since birth.

01-94 01-94

95 95+

96 Since birth

97 Refused

99 Don't know

95 95+

96 Since birth

97 Refused

99 Don't know

SkipInstructions:

(R)[store "R" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(96)[store "6" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

Instrument Variable Name: AHCL06T

QuestionText:

QuestionText:

2 of 2 * Enter time period for time with (fill: other) injury.

1 Day(s)

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

SkipInstructions:

(6) goto ERR2_AHCL06T [if [AHCL06N = Number greater than person years old and AHCL06T= 4]] goto ERR1_AHCL06T

Hard Edit: ERR_AHCL06T

* Time with condition cannot be greater than age.

* Please correct.

Survey form
view entire document:
text
image

Instrument Variable Name: AHCL06N

QuestionText:

QuestionText:

* Enter number for time with injury that caused your limitation.

* Enter '95'' for 95 or more.

* Enter "96" if since birth.

01-94 01-94

95 95+

96 Since birth

97 Refused

99 Don't know

95 95+

96 Since birth

97 Refused

99 Don't know

SkipInstructions:

(R)[store "R" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(96)[store "6" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

Instrument Variable Name: AHCL06T

QuestionText:

QuestionText:

2 of 2 * Enter time period for time with (fill: other) injury.

1 Day(s)

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

SkipInstructions:

(6) goto ERR2_AHCL06T [if [AHCL06N = Number greater than person years old and AHCL06T= 4]] goto ERR1_AHCL06T

Hard Edit: ERR_AHCL06T

* Time with condition cannot be greater than age.

* Please correct.

Survey form
view entire document:
text
image

Instrument Variable Name: AHCL06N

QuestionText:

QuestionText:

* Enter number for time with injury that caused your limitation.

* Enter '95'' for 95 or more.

* Enter "96" if since birth.

01-94 01-94

95 95+

96 Since birth

97 Refused

99 Don't know

95 95+

96 Since birth

97 Refused

99 Don't know

SkipInstructions:

(R)[store "R" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(96)[store "6" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

Instrument Variable Name: AHCL06T

QuestionText:

QuestionText:

2 of 2 * Enter time period for time with (fill: other) injury.

1 Day(s)

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

SkipInstructions:

(6) goto ERR2_AHCL06T [if [AHCL06N = Number greater than person years old and AHCL06T= 4]] goto ERR1_AHCL06T

Hard Edit: ERR_AHCL06T

* Time with condition cannot be greater than age.

* Please correct.

Survey form
view entire document:
text
image

Instrument Variable Name: AHCL06N

QuestionText:

QuestionText:

* Enter number for time with injury that caused your limitation.

* Enter '95'' for 95 or more.

* Enter "96" if since birth.

01-94 01-94

95 95+

96 Since birth

97 Refused

99 Don't know

95 95+

96 Since birth

97 Refused

99 Don't know

SkipInstructions:

(R)[store "R" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(96)[store "6" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

Instrument Variable Name: AHCL06T

QuestionText:

QuestionText:

2 of 2 * Enter time period for time with (fill: other) injury.

1 Day(s)

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

SkipInstructions:

(6) goto ERR2_AHCL06T [if [AHCL06N = Number greater than person years old and AHCL06T= 4]] goto ERR1_AHCL06T

Hard Edit: ERR_AHCL06T

* Time with condition cannot be greater than age.

* Please correct.

Survey form
view entire document:
text
image

Instrument Variable Name: AHCL06N

QuestionText:

QuestionText:

* Enter number for time with injury that caused your limitation.

* Enter '95'' for 95 or more.

* Enter "96" if since birth.

01-94 01-94

95 95+

96 Since birth

97 Refused

99 Don't know

95 95+

96 Since birth

97 Refused

99 Don't know

SkipInstructions:

(R)[store "R" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(96)[store "6" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

Instrument Variable Name: AHCL06T

QuestionText:

QuestionText:

2 of 2 * Enter time period for time with (fill: other) injury.

1 Day(s)

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

SkipInstructions:

(6) goto ERR2_AHCL06T [if [AHCL06N = Number greater than person years old and AHCL06T= 4]] goto ERR1_AHCL06T

Hard Edit: ERR_AHCL06T

* Time with condition cannot be greater than age.

* Please correct.

Survey form
view entire document:
text
image

Instrument Variable Name: AHCL06N

QuestionText:

QuestionText:

* Enter number for time with injury that caused your limitation.

* Enter '95'' for 95 or more.

* Enter "96" if since birth.

01-94 01-94

95 95+

96 Since birth

97 Refused

99 Don't know

95 95+

96 Since birth

97 Refused

99 Don't know

SkipInstructions:

(R)[store "R" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(96)[store "6" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

Instrument Variable Name: AHCL06T

QuestionText:

QuestionText:

2 of 2 * Enter time period for time with (fill: other) injury.

1 Day(s)

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

SkipInstructions:

(6) goto ERR2_AHCL06T [if [AHCL06N = Number greater than person years old and AHCL06T= 4]] goto ERR1_AHCL06T

Hard Edit: ERR_AHCL06T

* Time with condition cannot be greater than age.

* Please correct.

Survey form
view entire document:
text
image

Instrument Variable Name: AHCL06N

QuestionText:

QuestionText:

* Enter number for time with injury that caused your limitation.

* Enter '95'' for 95 or more.

* Enter "96" if since birth.

01-94 01-94

95 95+

96 Since birth

97 Refused

99 Don't know

95 95+

96 Since birth

97 Refused

99 Don't know

SkipInstructions:

(R)[store "R" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(96)[store "6" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

Instrument Variable Name: AHCL06T

QuestionText:

QuestionText:

2 of 2 * Enter time period for time with (fill: other) injury.

1 Day(s)

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

SkipInstructions:

(6) goto ERR2_AHCL06T [if [AHCL06N = Number greater than person years old and AHCL06T= 4]] goto ERR1_AHCL06T

Hard Edit: ERR_AHCL06T

* Time with condition cannot be greater than age.

* Please correct.

Survey form
view entire document:
text
image

Instrument Variable Name: AHCL06N

QuestionText:

QuestionText:

* Enter number for time with injury that caused your limitation.

* Enter '95'' for 95 or more.

* Enter "96" if since birth.

01-94 01-94

95 95+

96 Since birth

97 Refused

99 Don't know

95 95+

96 Since birth

97 Refused

99 Don't know

SkipInstructions:

(R)[store "R" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(96)[store "6" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

Instrument Variable Name: AHCL06T

QuestionText:

QuestionText:

2 of 2 * Enter time period for time with (fill: other) injury.

1 Day(s)

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

SkipInstructions:

(6) goto ERR2_AHCL06T [if [AHCL06N = Number greater than person years old and AHCL06T= 4]] goto ERR1_AHCL06T

Hard Edit: ERR_AHCL06T

* Time with condition cannot be greater than age.

* Please correct.

Survey form
view entire document:
text
image

Instrument Variable Name: AHCL06N

QuestionText:

QuestionText:

* Enter number for time with injury that caused your limitation.

* Enter '95'' for 95 or more.

* Enter "96" if since birth.

01-94 01-94

95 95+

96 Since birth

97 Refused

99 Don't know

95 95+

96 Since birth

97 Refused

99 Don't know

SkipInstructions:

(R)[store "R" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(96)[store "6" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

Instrument Variable Name: AHCL06T

QuestionText:

QuestionText:

2 of 2 * Enter time period for time with (fill: other) injury.

1 Day(s)

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

SkipInstructions:

(6) goto ERR2_AHCL06T [if [AHCL06N = Number greater than person years old and AHCL06T= 4]] goto ERR1_AHCL06T

Hard Edit: ERR_AHCL06T

* Time with condition cannot be greater than age.

* Please correct.

Survey form
view entire document:
text
image

Instrument Variable Name: AHCL06N

QuestionText:

QuestionText:

* Enter number for time with injury that caused your limitation.

* Enter '95'' for 95 or more.

* Enter "96" if since birth.

01-94 01-94

95 95+

96 Since birth

97 Refused

99 Don't know

95 95+

96 Since birth

97 Refused

99 Don't know

SkipInstructions:

(R)[store "R" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(96)[store "6" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

Instrument Variable Name: AHCL06T

QuestionText:

QuestionText:

2 of 2 * Enter time period for time with (fill: other) injury.

1 Day(s)

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

SkipInstructions:

(6) goto ERR2_AHCL06T [if [AHCL06N = Number greater than person years old and AHCL06T= 4]] goto ERR1_AHCL06T

Hard Edit: ERR_AHCL06T

* Time with condition cannot be greater than age.

* Please correct.

Survey form
view entire document:
text
image

Instrument Variable Name: AHCL06N

QuestionText:

QuestionText:

* Enter number for time with injury that caused your limitation.

* Enter '95'' for 95 or more.

* Enter "96" if since birth.

01-94 01-94

95 95+

96 Since birth

97 Refused

99 Don't know

95 95+

96 Since birth

97 Refused

99 Don't know

SkipInstructions:

(R)[store "R" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

(96)[store "6" in AHCL06T] [goto the next condition, in numerical order, selected at AFLHCA (AHS.200). If this is the last condition selected, goto SMKEV (next section)]

Instrument Variable Name: AHCL06T

QuestionText:

QuestionText:

2 of 2 * Enter time period for time with (fill: other) injury.

1 Day(s)

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

2 Week(s)

3 Month(s)

4 Year(s)

6 Since birth

7 Refused

9 Don't know

SkipInstructions:

(6) goto ERR2_AHCL06T [if [AHCL06N = Number greater than person years old and AHCL06T= 4]] goto ERR1_AHCL06T

Hard Edit: ERR_AHCL06T

* Time with condition cannot be greater than age.

* Please correct.

Survey form
view entire document:
text
image

AHS.300

How long have you had {condition AFLHCA}?

LTIME1

[ ] NUMBER:

(01-94) 1-94

(95) 95+

(96) Since birth

(97) Refused

(99) Don't know

(01-94) 1-94

(95) 95+

(96) Since birth

(97) Refused

(99) Don't know

ALUNIT1

[ ] TIME PERIOD:

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't know

[AHS.300 - AHS.336 are asked for each condition reported in AHS.200]

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't know

[AHS.300 - AHS.336 are asked for each condition reported in AHS.200]

Survey form
view entire document:
text
image

AHS.300

How long have you had {condition AFLHCA}?

LTIME1

[ ] NUMBER:

(01-94) 1-94

(95) 95+

(96) Since birth

(97) Refused

(99) Don't know

(01-94) 1-94

(95) 95+

(96) Since birth

(97) Refused

(99) Don't know

ALUNIT1

[ ] TIME PERIOD:

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't know

[AHS.300 - AHS.336 are asked for each condition reported in AHS.200]

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't know

[AHS.300 - AHS.336 are asked for each condition reported in AHS.200]

Survey form
view entire document:
text
image

AHS.300

How long have you had {condition AFLHCA}?

LTIME1

[ ] NUMBER:

(01-94) 1-94

(95) 95+

(96) Since birth

(97) Refused

(99) Don't know

(01-94) 1-94

(95) 95+

(96) Since birth

(97) Refused

(99) Don't know

ALUNIT1

[ ] TIME PERIOD:

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't know

[AHS.300 - AHS.336 are asked for each condition reported in AHS.200]

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't know

[AHS.300 - AHS.336 are asked for each condition reported in AHS.200]

Survey form
view entire document:
text
image

How long have you had {condition AFLHCA}?

LTIME1

[ ] NUMBER:

(01-94) 1-94

(95) 95+

(96) Since birth

(97) Refused

(99) Don't know

(01-94) 1-94

(95) 95+

(96) Since birth

(97) Refused

(99) Don't know

ALUNIT1

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't know

[AHS.300 - AHS.336 are asked for each condition reported in AHS.200]

Survey form
view entire document:
text
image

AHS.300

How long have you had {name the first condition AFLHCA1}?

AFLHCLN

[ ] NUMBER

(01-94) 1-94

(95) 95+

(96) Since birth

(97) Refused

(99) Don't Know

(01-94) 1-94

(95) 95+

(96) Since birth

(97) Refused

(99) Don't Know

AFLHCLT

[ ] TIME PERIOD

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know

AHS.301

How long have you had {name the second condition AFLHCA2}?

AFLHCLN2

[ ] NUMBER

(01-94) 1-94

(95)95+

(96)Since birth

(97) Refused

(99) Don't Know

(01-94) 1-94

(95)95+

(96)Since birth

(97) Refused

(99) Don't Know

AFLHCLT2

[ ] TIME PERIOD

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know

AHS.302

How long have you had {name the third condition AFLHCA3}?

AFLHCLN3

[ ] NUMBER

(01-94) 1-94

(95)95+

(96)Since birth

(97) Refused

(99) Don't Know

(01-94) 1-94

(95)95+

(96)Since birth

(97) Refused

(99) Don't Know

AFLHCLT3

[ ] TIME PERIOD

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know

AHS.303

How long have you had {name the fourth condition AFLHCA4}?

AFLHCLN4

[ ] NUMBER

(01-94) 1-94

(95)95+

(96)Since birth

(97) Refused

(99) Don't Know

(01-94) 1-94

(95)95+

(96)Since birth

(97) Refused

(99) Don't Know

AFLHCLT4

[ ]TIME PERIOD

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know

AHS.304

How long have you had {name the fifth condition AFLHCA5}?

AFLHCLN5

[ ] NUMBER

(01-94) 1-94

(95) 95+

(96) Since birth

(97) Refused

(99) Don't Know

(01-94) 1-94

(95) 95+

(96) Since birth

(97) Refused

(99) Don't Know

AFLHCLT5

[ ] TIME PERIOD

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know

Survey form
view entire document:
text
image

AHS.300

How long have you had {name the first condition AFLHCA1}?

AFLHCLN

[ ] NUMBER

(01-94) 1-94

(95) 95+

(96) Since birth

(97) Refused

(99) Don't Know

(01-94) 1-94

(95) 95+

(96) Since birth

(97) Refused

(99) Don't Know

AFLHCLT

[ ] TIME PERIOD

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know

AHS.301

How long have you had {name the second condition AFLHCA2}?

AFLHCLN2

[ ] NUMBER

(01-94) 1-94

(95)95+

(96)Since birth

(97) Refused

(99) Don't Know

(01-94) 1-94

(95)95+

(96)Since birth

(97) Refused

(99) Don't Know

AFLHCLT2

[ ] TIME PERIOD

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know

AHS.302

How long have you had {name the third condition AFLHCA3}?

AFLHCLN3

[ ] NUMBER

(01-94) 1-94

(95)95+

(96)Since birth

(97) Refused

(99) Don't Know

(01-94) 1-94

(95)95+

(96)Since birth

(97) Refused

(99) Don't Know

AFLHCLT3

[ ] TIME PERIOD

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know

AHS.303

How long have you had {name the fourth condition AFLHCA4}?

AFLHCLN4

[ ] NUMBER

(01-94) 1-94

(95)95+

(96)Since birth

(97) Refused

(99) Don't Know

(01-94) 1-94

(95)95+

(96)Since birth

(97) Refused

(99) Don't Know

AFLHCLT4

[ ]TIME PERIOD

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know

AHS.304

How long have you had {name the fifth condition AFLHCA5}?

AFLHCLN5

[ ] NUMBER

(01-94) 1-94

(95) 95+

(96) Since birth

(97) Refused

(99) Don't Know

(01-94) 1-94

(95) 95+

(96) Since birth

(97) Refused

(99) Don't Know

AFLHCLT5

[ ] TIME PERIOD

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know

(1) Days

(2) Weeks

(3) Months

(4) Years

(6) Since birth

(7) Refused

(9) Don't Know