Survey Text

2014 2009 2004 1999
2013 2008 2003 1998
2012 2007 2002 1997
2011 2006 2001
2010 2005 2000
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2014

No questionnaire text is available for this sample.


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2013
Survey form view entire document:  text  image

Question ID:FIJ.060_00.000

Instrument Variable Name: IPHOW
Question Text:
? [F1] [fill1: How did [fill2: your/ALIAS's] [fill3: injury/poisoning] on [fill4: ^IPDATEM ^IPDATED (starting with most recent if multiple)] happen?/How did this [fill3: injury/poisoning] happen?] Please describe fully the circumstances or events leading to the [fill3: injury/poisoning], and any objects, substances, or other people involved.
* Enter the verbatim response, probing for as much detail as possible, including specifically what the person was doing at the time and all circumstances surrounding the event. Record all volunteered information.
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All injury/poisoning episodes for which a medical professional was consulted
Skip Instructions:
(verbatim) [if an injury episode, go to ICAUS; else, if a poisoning episode, go to PPCC]
(R) [if an injury episode, fill "R" in ICAUS and go to IJBODY; else, if a poisoning episode, go to PPCC]
(D) [if an injury episode, fill "D" in ICAUS and go to IJBODY; else, if a poisoning episode, go to PPCC]
Question ID:FIJ.065_00.000

Instrument Variable Name: ICAUS
Question Text:
? [F1]
* Do not read. * Enter the number which best describes the cause of the person's injury from the list below.
01 In a motor vehicle
02 On a bike, scooter, skateboard, skates, skis, horse, etc.
03 Pedestrian who was struck by a vehicle such as a car or bicycle
04 In a boat, train, or plane
05 Fall
06 Burned or scalded by substances such as hot objects or liquids, fire, or chemicals
07 Other
97 Refused
99 Don't know
Universe Text All injury episodes for which a medical professional was consulted and don't know or refused was not entered at IPHOW
Skip Instructions:
go to IJBODY

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2012
Survey form view entire document:  text  image

Question ID:FIJ.060_00.000

Instrument Variable Name: IPHOW
Question Text:
? [F1] [fill1: How did [fill2: your/ALIAS's] [fill3: injury/poisoning] on [fill4: ^IPDATEM ^IPDATED (starting with most recent if multiple)] happen?/How did this [fill3: injury/poisoning] happen?] Please describe fully the circumstances or events leading to the [fill3: injury/poisoning], and any objects, substances, or other people involved.
* Enter the verbatim response, probing for as much detail as possible, including specifically what the person was doing at the time and all circumstances surrounding the event. Record all volunteered information.
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All injury/poisoning episodes for which a medical professional was consulted
Skip Instructions:
(verbatim) [if an injury episode, go to ICAUS; else, if a poisoning episode, go to PPCC]
(R) [if an injury episode, fill "R" in ICAUS and go to IJBODY; else, if a poisoning episode, go to PPCC]
(D) [if an injury episode, fill "D" in ICAUS and go to IJBODY; else, if a poisoning episode, go to PPCC]
Question ID:FIJ.065_00.000

Instrument Variable Name: ICAUS
Question Text:
? [F1]
* Do not read. * Enter the number which best describes the cause of the person's injury from the list below.
01 In a motor vehicle
02 On a bike, scooter, skateboard, skates, skis, horse, etc.
03 Pedestrian who was struck by a vehicle such as a car or bicycle
04 In a boat, train, or plane
05 Fall
06 Burned or scalded by substances such as hot objects or liquids, fire, or chemicals
07 Other
97 Refused
99 Don't know
Universe Text All injury episodes for which a medical professional was consulted and don't know or refused was not entered at IPHOW
Skip Instructions:
go to IJBODY

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2011
Survey form view entire document:  text  image

Question ID:FIJ.060_00.000

Instrument Variable Name: IPHOW
Question Text:
? [F1] [fill1: How did [fill2: your/ALIAS's] [fill3: injury/poisoning] on [fill4: ^IPDATEM ^IPDATED (starting with most recent if multiple)] happen?/How did this [fill3: injury/poisoning] happen?] Please describe fully the circumstances or events leading to the [fill3: injury/poisoning], and any objects, substances, or other people involved.
* Enter the verbatim response, probing for as much detail as possible, including specifically what the person was doing at the time and all circumstances surrounding the event. Record all volunteered information.
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All injury/poisoning episodes for which a medical professional was consulted
Skip Instructions:
(verbatim) [if an injury episode, go to ICAUS; else, if a poisoning episode, go to PPCC]
(R) [if an injury episode, fill "R" in ICAUS and go to IJBODY; else, if a poisoning episode, go to PPCC]
(D) [if an injury episode, fill "D" in ICAUS and go to IJBODY; else, if a poisoning episode, go to PPCC]
Question ID:FIJ.065_00.000

Instrument Variable Name: ICAUS
Question Text:
? [F1]
* Do not read. * Enter the number which best describes the cause of the person's injury from the list below.
01 In a motor vehicle
02 On a bike, scooter, skateboard, skates, skis, horse, etc.
03 Pedestrian who was struck by a vehicle such as a car or bicycle
04 In a boat, train, or plane
05 Fall
06 Burned or scalded by substances such as hot objects or liquids, fire, or chemicals
07 Other
97 Refused
99 Don't know
Universe Text All injury episodes for which a medical professional was consulted and don't know or refused was not entered at IPHOW
Skip Instructions:
go to IJBODY

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2010
Survey form view entire document:  text  image

Question ID:FIJ.060_00.000

Instrument Variable Name: IPHOW
Question Text:
? [F1] [fill1: How did [fill2: your/ALIAS's] [fill3: injury/poisoning] on [fill4: ^IPDATEM ^IPDATED (starting with most recent if multiple)] happen?/How did this [fill3: injury/poisoning] happen?] Please describe fully the circumstances or events leading to the [fill3: injury/poisoning], and any objects, substances, or other people involved.
* Enter the verbatim response, probing for as much detail as possible, including specifically what the person was doing at the time and all circumstances surrounding the event. Record all volunteered information.
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All injury/poisoning episodes for which a medical professional was consulted
Skip Instructions:
(verbatim) [if an injury episode, go to ICAUS; else, if a poisoning episode, go to PPCC]
(R) [if an injury episode, fill "R" in ICAUS and go to IJBODY; else, if a poisoning episode, go to PPCC]
(D) [if an injury episode, fill "D" in ICAUS and go to IJBODY; else, if a poisoning episode, go to PPCC]
Question ID:FIJ.065_00.000

Instrument Variable Name: ICAUS
Question Text:
? [F1]
* Do not read. * Enter the number which best describes the cause of the person's injury from the list below.
01 In a motor vehicle
02 On a bike, scooter, skateboard, skates, skis, horse, etc.
03 Pedestrian who was struck by a vehicle such as a car or bicycle
04 In a boat, train, or plane
05 Fall
06 Burned or scalded by substances such as hot objects or liquids, fire, or chemicals
07 Other
97 Refused
99 Don't know
Universe Text All injury episodes for which a medical professional was consulted and don't know or refused was not entered at IPHOW
Skip Instructions:
go to IJBODY

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2009
Survey form view entire document:  text  image

Question ID: FIJ.065_00.000

Instrument Variable Name: ICAUS
Question Text: ? [F1]
* Do not read.
* Enter the number which best describes the cause of the person's injury from the list below.
01 In a motor vehicle
02 On a bike, scooter, skateboard, skates, ski, horse, etc.
03 Pedestrian who was struck by a vehicle such as a car or bicycle
04 In a boat, train, or plane
05 Fall
06 Burned or scalded by substances (hot objects,fire,liquid,chemical)
07 Other
97 Refused
99 Don't know
Universe Text: All injury episodes for which a medical professional was consulted and don't know or refused was not entered at IPHOW
Skip Instructions:
goto IJBODY

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2008

No questionnaire text is available for this sample.


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2007
Survey form view entire document:  text  image

Question ID: FIJ.065_00.000

Instrument Variable Name: ICAUS
Question Text: ? [F1]
* Do not read.
* Enter the number which best describes the cause of the person's injury from the list below.
01 In a motor vehicle
02 On a bike, scooter, skateboard, skates, ski, horse, etc.
03 Pedestrian who was struck by a vehicle such as a car or bicycle
04 In a boat, train, or plane
05 Fall
06 Burned or scalded by substances (hot objects,fire,liquid,chemical)
07 Other
97 Refused
99 Don't know
Universe Text: All injury episodes for which a medical professional was consulted and don't know or refused was not entered at IPHOW
Skip Instructions:
goto IJBODY

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2006
Survey form view entire document:  text  image

Question ID: FIJ.065_00.000

Instrument Variable Name: ICAUS
Question Text: ? [F1]
* Do not read.
* Enter the number which best describes the cause of the person's injury from the list below.
01 In a motor vehicle
02 On a bike, scooter, skateboard, skates, ski, horse, etc.
03 Pedestrian who was struck by a vehicle such as a car or bicycle
04 In a boat, train, or plane
05 Fall
06 Burned or scalded by substances (hot objects,fire,liquid,chemical)
07 Other
97 Refused
99 Don't know
Universe Text: All injury episodes for which a medical professional was consulted and don't know or refused was not entered at IPHOW
Skip Instructions:
goto IJBODY

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2005
Survey form view entire document:  text  image

Question ID: FIJ.065_00.000

Instrument Variable Name: ICAUS
Question Text: ? [F1]
* Do not read.
* Enter the number which best describes the cause of the person's injury from the list below.
01 In a motor vehicle
02 On a bike, scooter, skateboard, skates, ski, horse, etc.
03 Pedestrian who was struck by a vehicle such as a car or bicycle
04 In a boat, train, or plane
05 Fall
06 Burned or scalded by substances (hot objects,fire,liquid,chemical)
07 Other
97 Refused
99 Don't know
Universe Text: All injury episodes for which a medical professional was consulted and don't know or refused was not entered at IPHOW
Skip Instructions:
goto IJBODY

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2004
Survey form view entire document:  text  image

Question ID: FIJ.060_00.000

Instrument Variable Name: IPHOW
Question Text: ? [F1]

[fill1: How did [fill2: your/ALIAS's] [fill3: injury/poisoning] on [fill4: ^IPDATEM ^IPDATED (starting with most recent if multiple)] happen?/How did this [fill3: injury/poisoning] happen?] Please describe fully the circumstances or events leading to the [fill3: injury/poisoning], and any objects, substances, or other people involved.
* Enter the verbatim response, probing for as much detail as possible, including specifically what the person was doing at
the time and all circumstances surrounding the event. Record all volunteered information.
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text: All injury/poisoning episodes for which a medical professional was consulted
Skip Instructions: (verbatim)
[if an injury episode, goto ICAUS; else, if a poisoning episode, goto PPCC]
(R) [if an injury episode, fill "R" in ICAUS and goto IJBODY; else, if a poisoning episode, goto PPCC]
(D) [if an injury episode, fill "D" in ICAUS and goto IJBODY; else, if a poisoning episode, goto PPCC]
Question ID: FIJ.065_00.000

Instrument Variable Name: ICAUS
Question Text: ? [F1]
* Do not read.
* Enter the number which best describes the cause of the person's injury from the list below.
01 In a motor vehicle
02 On a bike, scooter, skateboard, skates, ski, horse, etc.
03 Pedestrian who was struck by a vehicle such as a car or bicycle
04 In a boat, train, or plane
05 Fall
06 Burned or scalded by substances (hot objects,fire,liquid,chemical)
07 Other
97 Refused
99 Don't know
Universe Text: All injury episodes for which a medical professional was consulted and don't know or refused was not entered at IPHOW
Skip Instructions:
goto IJBODY

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2003
Survey form view entire document:  text  image

FIJ.080

FR: ENTER THE FIRST APPROPRIATE BOX WHICH DESCRIBES THE CAUSE OF THE PERSON'S INJURY/POISONING FROM THE LIST BELOW.
CAUSNEW
(01) Transportation, including motor vehicle/bicycle/motorcycle/pedestrian/train/boat/airplane (FIJ.090)
(02) Fire/burn/scald related (FIJ.150)
(03) Fall (FIJ.171)
(04) Poisoning (FIJ.195)
(05) Overexertion/strenuous movements (FIJ.200)
(06) Struck by object or person (FIJ.200)
(07) Animal or insect bite (FIJ.191)
(08) Cut/pierce (FIJ.200)
(09) Machinery (FIJ.200)
(10) Other (FIJ.200)
(97) Refused (FIJ.200)
(99) Don't know (FIJ.200)

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2002
Survey form view entire document:  text  image

FIJ.080

FR: ENTER THE FIRST APPROPRIATE BOX WHICH DESCRIBES THE CAUSE OF THE PERSON'S INJURY/POISONING FROM THE LIST BELOW.
CAUSNEW
(01) Transportation, including motor vehicle/bicycle/motorcycle/pedestrian/train/boat/airplane (FIJ.090)
(02) Fire/burn/scald related (FIJ.150)
(03) Fall (FIJ.171)
(04) Poisoning (FIJ.195)
(05) Overexertion/strenuous movements (FIJ.200)
(06) Struck by object or person (FIJ.200)
(07) Animal or insect bite (FIJ.191)
(08) Cut/pierce (FIJ.200)
(09) Machinery (FIJ.200)
(10) Other (FIJ.200)
(97) Refused (FIJ.200)
(99) Don't know (FIJ.200)

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2001
Survey form view entire document:  text  image

FIJ.080

FR: ENTER THE FIRST APPROPRIATE BOX WHICH DESCRIBES THE CAUSE OF THE PERSON'S INJURY/POISONING FROM THE LIST BELOW.
CAUSNEW
(01) Transportation, including motor vehicle/bicycle/motorcycle/pedestrian/train/boat/airplane (FIJ.090)
(02) Fire/burn/scald related (FIJ.150)
(03) Fall (FIJ.171)
(04) Poisoning (FIJ.195)
(05) Overexertion/strenuous movements (FIJ.200)
(06) Struck by object or person (FIJ.200)
(07) Animal or insect bite (FIJ.191)
(08) Cut/pierce (FIJ.200)
(09) Machinery (FIJ.200)
(10) Other (FIJ.200)
(97) Refused (FIJ.200)
(99) Don't know (FIJ.200)

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2000
Survey form view entire document:  text  image

FIJ.080

FR: ENTER THE FIRST APPROPRIATE BOX WHICH DESCRIBES THE CAUSE OF THE PERSON'S INJURY/POISONING FROM THE LIST BELOW.
CAUSNEW
(01) Transportation, including motor vehicle/bicycle/motorcycle/pedestrian/train/boat/airplane (FIJ.090)
(02) Fire/burn/scald related (FIJ.150)
(03) Fall (FIJ.171)
(04) Poisoning (FIJ.195)
(05) Overexertion/strenuous movements (FIJ.200)
(06) Struck by object or person (FIJ.200)
(07) Animal or insect bite (FIJ.191)
(08) Cut/pierce (FIJ.200)
(09) Machinery (FIJ.200)
(10) Other (FIJ.200)
(97) Refused (FIJ.200)
(99) Don't know (FIJ.200)

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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

No questionnaire text is available for this sample.