Survey Text

2003
2002
2001
2000
1999
1998
1997
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2003
Survey form view entire document:  text  image
CIM.050

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a HIB shot? (This is for meningitis and called Haemophilus influenzae (HA-MA-FI-LUS IN-FLU-EN-ZI) type B, Hib vaccine or H.Flu vaccine).
HIB
(00) None (CIM.060)
(01-08) 1-8 shots
(97) Refused (CIM.060)
(99) Don't Know (CIM.060)

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2002
Survey form view entire document:  text  image
CIM.050

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a HIB shot? (This is for meningitis and called Haemophilus influenzae (HA-MA-FI-LUS IN-FLU-EN-ZI) type B, Hib vaccine or H.Flu vaccine).
HIB
(00) None (CIM.060)
(01-08) 1-8 shots
(97) Refused (CIM.060)
(99) Don't Know (CIM.060)

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2001
Survey form view entire document:  text  image
CIM.050

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a HIB shot? (This is for meningitis and called Haemophilus influenzae (HA-MA-FI-LUS IN-FLU-EN-ZI) type B, Hib vaccine or H.Flu vaccine).
HIB
(00) None (CIM.060)
(01-08) 1-8 shots
(97) Refused (CIM.060)
(99) Don't Know (CIM.060)

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2000
Survey form view entire document:  text  image
CIM.050

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a HIB shot? (This is for meningitis and called Haemophilus influenzae (HA-MA-FI-LUS IN-FLU-EN-ZI) type B, Hib vaccine or H.Flu vaccine).
HIB
(00) None (CIM.060)
(01-08) 1-8 shots
(97) Refused (CIM.060)
(99) Don't Know (CIM.060)

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1999
Survey form view entire document:  text  image
CIM.050

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a HIB shot? (This is for meningitis and called Haemophilus influenzae (HA-MA-FI-LUS IN-FLU-EN-ZI) type B, Hib vaccine or H.Flu vaccine).
HIB
(00) None (CIM.060)
(01-08) 1-8 shots
(97) Refused (CIM.060)
(99) Don't Know (CIM.060)

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1998
Survey form view entire document:  text  image
CIM.050

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a HIB shot? (This is for meningitis and called Haemophilus influenzae (HA-MA-FI-LUS IN-FLU-EN-ZI) type B, Hib vaccine or H.Flu vaccine).
HIB
(00) None (CIM.060)
(01-08) 1-8 shots
(97) Refused (CIM.060)
(99) Don't Know (CIM.060)

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1997
Survey form view entire document:  text  image
CIM.050

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a HIB shot? (This is for meningitis and called Haemophilus influenzae (HA-MA-FI-LUS IN-FLU-EN-ZI) type B, Hib vaccine or H.Flu vaccine).
HIB
(00) None (CIM.060)
(01-08) 1-8 shots
(97) Refused (CIM.060)
(99) Don't Know (CIM.060)