Instrument Variable Name: VIS_0
Questionnaire File Name: Sample Adult
Question Text:

Now I am going to ask you some questions about your ability to do different activities, and how you have been feeling.
Although some of these questions may seem similar to ones you have already answered, it is important that we ask them all.
Do you wear glasses?

1 Yes
2 No
7 Refused
9 Don't know

Universe Text: Sample adults 18+
Skip Instructions:

(1,2,R,D) goto VIS_SS

Instrument Variable Name: VIS_0
Question Text:

Now I am going to ask you some questions about your ability to do different activities, and how you have been feeling.
Although some of these questions may seem similar to ones you have already answered, it is important that we ask them all.
Do you wear glasses?

1 Yes
2 No
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1,2,R,D) go to VIS_SS

Instrument Variable Name: VIS_0
Question Text:

Now I am going to ask you some questions about your ability to do different activities, and how you have been feeling.
Although some of these questions may seem similar to ones you have already answered, it is important that we ask them all.
Do you wear glasses?

1 Yes
2 No
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1,2,R,D) go to VIS_SS

Instrument Variable Name: VIS_0
Question Text:

Now I am going to ask you some questions about your ability to do different activities, and how you have been feeling.
Although some of these questions may seem similar to ones you have already answered, it is important that we ask them all.
Do you wear glasses?

1 Yes
2 No
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1,2,R,D) go to VIS_SS

Instrument Variable Name: VIS_0
Question Text:

Now I am going to ask you some questions about your ability to do different activities, and how you have been feeling.
Although some of these questions may seem similar to ones you have already answered, it is important that we ask them all.
Do you wear glasses?

1 Yes
2 No
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1,2,R,D) go to VIS_SS

Instrument Variable Name: VIS_0
Question Text:

Now I am going to ask you some questions about your ability to do different activities, and how you have been feeling.
Although some of these questions may seem similar to ones you have already answered, it is important that we ask them all.
Do you wear glasses?

1 Yes
2 No
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1,2,R,D) go to VIS_SS

Instrument Variable Name: VIS_0
Question Text:

Now I am going to ask you some questions about your ability to do different activities, and how you have been feeling.
Although some of these questions may seem similar to ones you have already answered, it is important that we ask them all.
Do you wear glasses?

1 Yes
2 No
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1,2,R,D) go to VIS_SS

1[] Y
2[] N (3)

1[] Both glasses and contacts
2[] Glasses only
3[] Contacts only

(1) Eyeglasses?

[] Y
[] N

(2) Contact lenses?

[] Y
[] N

(3) A hearing aid?

[] Y
[] N

1 [] Eyeglasses
2 [] Contact lenses
3 [] Hearing aid

(1) Eyeglasses?

[] Y
[] N

(2) Contact lenses?

[] Y
[] N

(3) A hearing aid?

[] Y
[] N

1 [] Eyeglasses
2 [] Contact lenses
3 [] Hearing aid

2. Eyeglasses?

[] Y
[] N

[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7
[] 8
[] 9
[] 10