Survey Text

2003
2002
2001
2000
1999
1998
1997
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2003
Survey form view entire document:  text  image
FIJ.040

[If IJNO3M_T = 1]

Now I'm going to ask a few questions about {your/subject name}'s most recent injury/poisoning.
When did it happen?

FR: SHOW CALENDAR CARD - PROBE FOR SPECIFIC DATE
IJDATE_M MONTH:
IJDATE_D DAY:
IJDATE_Y YEAR:
[If IJNO3M_T gt 1 and the other injuries are asked]

We just talked about {your/subject name}'s injury/poisoning on {recent injury date}. When did {your/subject name}'s injury BEFORE THAT happen?

FR: SHOW CALENDAR CARD - PROBE FOR SPECIFIC DATE
IJDATE_M MONTH:
IJDATE_D DAY:
IJDATE_Y YEAR:

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2002
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FIJ.040

[If IJNO3M_T = 1]

Now I'm going to ask a few questions about {your/subject name}'s most recent injury/poisoning.
When did it happen?

FR: SHOW CALENDAR CARD - PROBE FOR SPECIFIC DATE
IJDATE_M MONTH:
IJDATE_D DAY:
IJDATE_Y YEAR:
[If IJNO3M_T gt 1 and the other injuries are asked]

We just talked about {your/subject name}'s injury/poisoning on {recent injury date}. When did {your/subject name}'s injury BEFORE THAT happen?

FR: SHOW CALENDAR CARD - PROBE FOR SPECIFIC DATE
IJDATE_M MONTH:
IJDATE_D DAY:
IJDATE_Y YEAR:

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2001
Survey form view entire document:  text  image
FIJ.040

[If IJNO3M_T = 1]

Now I'm going to ask a few questions about {your/subject name}'s most recent injury/poisoning.
When did it happen?

FR: SHOW CALENDAR CARD - PROBE FOR SPECIFIC DATE
IJDATE_M MONTH:
IJDATE_D DAY:
IJDATE_Y YEAR:
[If IJNO3M_T gt 1 and the other injuries are asked]

We just talked about {your/subject name}'s injury/poisoning on {recent injury date}. When did {your/subject name}'s injury BEFORE THAT happen?

FR: SHOW CALENDAR CARD - PROBE FOR SPECIFIC DATE
IJDATE_M MONTH:
IJDATE_D DAY:
IJDATE_Y YEAR:

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2000
Survey form view entire document:  text  image
FIJ.040

[If IJNO3M_T = 1]

Now I'm going to ask a few questions about {your/subject name}'s most recent injury/poisoning.
When did it happen?

FR: SHOW CALENDAR CARD - PROBE FOR SPECIFIC DATE
IJDATE_M MONTH:
IJDATE_D DAY:
IJDATE_Y YEAR:
[If IJNO3M_T gt 1 and the other injuries are asked]

We just talked about {your/subject name}'s injury/poisoning on {recent injury date}. When did {your/subject name}'s injury BEFORE THAT happen?

FR: SHOW CALENDAR CARD - PROBE FOR SPECIFIC DATE
IJDATE_M MONTH:
IJDATE_D DAY:
IJDATE_Y YEAR:

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1999

No questionnaire text is available for this sample.


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1998

No questionnaire text is available for this sample.


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1997
Survey form view entire document:  text  image
FIJ.040

[If FIJ.030 = 1, ask:]
When did {subject's name} injury happen?
IJDATE_M MONTH: _____
IJDATE_D DAY: _____
IJDATE_Y YEAR: _____
[If FIJ.030 greater than 1, ask:]
Now I'm going to ask a few questions about {subject's name} most recent injury. When did that injury happen?
IJDATE_M MONTH: _____
IJDATE_D DAY: _____
IJDATE_Y YEAR: _____
[If FIJ.030 = 2 or more, ask:]
We just talked about {subject's name} injury on {recent injury date}. When did {subject's name} injury BEFORE THAT happen?
IJDATE_M MONTH: _____
IJDATE_D DAY: _____
IJDATE_Y YEAR: _____