Refer to age.

2a. During those 2 weeks, did -- miss any time from a job or business because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from -- job or business because of illness or injury?

3a. During those 2 weeks, did -- miss any time from school because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from school because of illness or injury?

4a. During those 2 weeks, did -- stay in bed because of illness or injury?

b. During that 2-week period, how many days did -- stay in bed more than half of the day because of illness or injury?

Refer to 2b, 3b and 4b.
6a. (Not counting the day(s)
[- missed from work
- missed from school
- (and) in bed],
was there any (OTHER) time during those 2 weeks that -- cut down on the things -- usually does because of illness or injury?

b. (Again, not counting the day(s)
[- missed from work
- missed from school
- (and) in bed,]
During that period, how many (OTHER) days did -- cut down for more than half of the day because of illness or injury?

Refer to age.

2a. During those 2 weeks, did -- miss any time from a job or business because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from -- job or business because of illness or injury?

3a. During those 2 weeks, did -- miss any time from school because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from school because of illness or injury?

4a. During those 2 weeks, did -- stay in bed because of illness or injury?

b. During that 2-week period, how many days did -- stay in bed more than half of the day because of illness or injury?

Refer to 2b, 3b and 4b.
6a. (Not counting the day(s)
[- missed from work
- missed from school
- (and) in bed],
was there any (OTHER) time during those 2 weeks that -- cut down on the things -- usually does because of illness or injury?

b. (Again, not counting the day(s)
[- missed from work
- missed from school
- (and) in bed,]
During that period, how many (OTHER) days did -- cut down for more than half of the day because of illness or injury?

2a. During those 2 weeks, did -- miss any time from a job or business because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from -- job or business because of illness or injury?

3a. During those 2 weeks, did -- miss any time from school because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from school because of illness or injury?

4a. During those 2 weeks, did -- stay in bed because of illness or injury?

b. During that 2-week period, how many days did -- stay in bed more than half of the day because of illness or injury?

Refer to 2b, 3b and 4b.
6a. (Not counting the day(s)
[- missed from work
- missed from school
- (and) in bed],
was there any (OTHER) time during those 2 weeks that -- cut down on the things -- usually does because of illness or injury?

b. (Again, not counting the day(s)
[- missed from work
- missed from school
- (and) in bed,]
During that period, how many (OTHER) days did -- cut down for more than half of the day because of illness or injury?

Refer to age.

2a. During those 2 weeks, did -- miss any time from a job or business because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from -- job or business because of illness or injury?

3a. During those 2 weeks, did -- miss any time from school because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from school because of illness or injury?

4a. During those 2 weeks, did -- stay in bed because of illness or injury?

b. During that 2-week period, how many days did -- stay in bed more than half of the day because of illness or injury?

Refer to 2b, 3b and 4b.
6a. (Not counting the day(s)
[- missed from work
- missed from school
- (and) in bed],
was there any (OTHER) time during those 2 weeks that -- cut down on the things -- usually does because of illness or injury?

b. (Again, not counting the day(s)
[- missed from work
- missed from school
- (and) in bed,]
During that period, how many (OTHER) days did -- cut down for more than half of the day because of illness or injury?

Refer to age.

2a. During those 2 weeks, did -- miss any time from a job or business because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from -- job or business because of illness or injury?

3a. During those 2 weeks, did -- miss any time from school because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from school because of illness or injury?

4a. During those 2 weeks, did -- stay in bed because of illness or injury?

b. During that 2-week period, how many days did -- stay in bed more than half of the day because of illness or injury?

Refer to 2b, 3b and 4b.
6a. (Not counting the day(s)
[- missed from work
- missed from school
- (and) in bed],
was there any (OTHER) time during those 2 weeks that -- cut down on the things -- usually does because of illness or injury?

b. (Again, not counting the day(s)
[- missed from work
- missed from school
- (and) in bed,]
During that period, how many (OTHER) days did -- cut down for more than half of the day because of illness or injury?

Refer to age.

2a. During those 2 weeks, did -- miss any time from a job or business because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from -- job or business because of illness or injury?

3a. During those 2 weeks, did -- miss any time from school because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from school because of illness or injury?

4a. During those 2 weeks, did -- stay in bed because of illness or injury?

b. During that 2-week period, how many days did -- stay in bed more than half of the day because of illness or injury?

Refer to 2b, 3b and 4b.
6a. (Not counting the day(s)
[- missed from work
- missed from school
- (and) in bed],
was there any (OTHER) time during those 2 weeks that -- cut down on the things -- usually does because of illness or injury?

b. (Again, not counting the day(s)
[- missed from work
- missed from school
- (and) in bed,]
During that period, how many (OTHER) days did -- cut down for more than half of the day because of illness or injury?

Refer to age.

2a. During those 2 weeks, did -- miss any time from a job or business because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from -- job or business because of illness or injury?

3a. During those 2 weeks, did -- miss any time from school because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from school because of illness or injury?

4a. During those 2 weeks, did -- stay in bed because of illness or injury?

b. During that 2-week period, how many days did -- stay in bed more than half of the day because of illness or injury?

Refer to 2b, 3b and 4b.
6a. (Not counting the day(s)
[- missed from work
- missed from school
- (and) in bed],
was there any (OTHER) time during those 2 weeks that -- cut down on the things -- usually does because of illness or injury?

b. (Again, not counting the day(s)
[- missed from work
- missed from school
- (and) in bed,]
During that period, how many (OTHER) days did -- cut down for more than half of the day because of illness or injury?

Refer to age.

2a. During those 2 weeks, did -- miss any time from a job or business because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from -- job or business because of illness or injury?

3a. During those 2 weeks, did -- miss any time from school because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from school because of illness or injury?

4a. During those 2 weeks, did -- stay in bed because of illness or injury?

b. During that 2-week period, how many days did -- stay in bed more than half of the day because of illness or injury?

Refer to 2b, 3b and 4b.
6a. (Not counting the day(s)
[- missed from work
- missed from school
- (and) in bed],
was there any (OTHER) time during those 2 weeks that -- cut down on the things -- usually does because of illness or injury?

b. (Again, not counting the day(s)
[- missed from work
- missed from school
- (and) in bed,]
During that period, how many (OTHER) days did -- cut down for more than half of the day because of illness or injury?

Refer to age.

2a. During those 2 weeks, did -- miss any time from a job or business because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from -- job or business because of illness or injury?

3a. During those 2 weeks, did -- miss any time from school because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from school because of illness or injury?

4a. During those 2 weeks, did -- stay in bed because of illness or injury?

b. During that 2-week period, how many days did -- stay in bed more than half of the day because of illness or injury?

Refer to 2b, 3b and 4b.
6a. (Not counting the day(s)
[- missed from work
- missed from school
- (and) in bed],
was there any (OTHER) time during those 2 weeks that -- cut down on the things -- usually does because of illness or injury?

b. (Again, not counting the day(s)
[- missed from work
- missed from school
- (and) in bed,]
During that period, how many (OTHER) days did -- cut down for more than half of the day because of illness or injury?

Refer to age.

2a. During those 2 weeks, did -- miss any time from a job or business because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from -- job or business because of illness or injury?

3a. During those 2 weeks, did -- miss any time from school because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from school because of illness or injury?

4a. During those 2 weeks, did -- stay in bed because of illness or injury?

b. During that 2-week period, how many days did -- stay in bed more than half of the day because of illness or injury?

Refer to 2b, 3b and 4b.
6a. (Not counting the day(s)

was there any (OTHER) time during those 2 weeks that -- cut down on the things -- usually does because of illness or injury?

b. (Again, not counting the day(s)

During that period, how many (OTHER) days did -- cut down for more than half of the day because of illness or injury?

Refer to age.

2a. During those 2 weeks, did -- miss any time from a job or business because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from -- job or business because of illness or injury?

3a. During those 2 weeks, did -- miss any time from school because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from school because of illness or injury?

4a. During those 2 weeks, did -- stay in bed because of illness or injury?

b. During that 2-week period, how many days did -- stay in bed more than half of the day because of illness or injury?

Refer to 2b, 3b and 4b.
6a. (Not counting the day(s)

was there any (OTHER) time during those 2 weeks that -- cut down on the things -- usually does because of illness or injury?

b. (Again, not counting the day(s)

During that period, how many (OTHER) days did -- cut down for more than half of the day because of illness or injury?

Refer to age.

2a. During those 2 weeks, did -- miss any time from a job or business because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from -- job or business because of illness or injury?

3a. During those 2 weeks, did -- miss any time from school because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from school because of illness or injury?

4a. During those 2 weeks, did -- stay in bed because of illness or injury?

b. During that 2-week period, how many days did -- stay in bed more than half of the day because of illness or injury?

Refer to 2b, 3b and 4b.
6a. (Not counting the day(s)

was there any (OTHER) time during those 2 weeks that -- cut down on the things -- usually does because of illness or injury?

b. (Again, not counting the day(s)

During that period, how many (OTHER) days did -- cut down for more than half of the day because of illness or injury?

Refer to age.

2a. During those 2 weeks, did -- miss any time from a job or business because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from -- job or business because of illness or injury?

3a. During those 2 weeks, did -- miss any time from school because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from school because of illness or injury?

4a. During those 2 weeks, did -- stay in bed because of illness or injury?

b. During that 2-week period, how many days did -- stay in bed more than half of the day because of illness or injury?

Refer to age.

2a. During those 2 weeks, did -- miss any time from a job or business because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from -- job or business because of illness or injury?

3a. During those 2 weeks, did -- miss any time from school because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from school because of illness or injury?

4a. During those 2 weeks, did -- stay in bed because of illness or injury?

b. During that 2-week period, how many days did -- stay in bed more than half of the day because of illness or injury?

Refer to 2b, 3b and 4b.
6a. (Not counting the day(s)

was there any (OTHER) time during those 2 weeks that -- cut down on the things -- usually does because of illness or injury?

b. (Again, not counting the day(s)

During that period, how many (OTHER) days did -- cut down for more than half of the day because of illness or injury?

Refer to age.

2a. During those 2 weeks, did -- miss any time from a job or business because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from -- job or business because of illness or injury?

3a. During those 2 weeks, did -- miss any time from school because of illness or injury?

b. During that 2-week period, how many days did -- miss more than half of the day from school because of illness or injury?

4a. During those 2 weeks, did -- stay in bed because of illness or injury?

b. During that 2-week period, how many days did -- stay in bed more than half of the day because of illness or injury?

Refer to 2b and 3b

Refer to 2b, 3b and 4b.
6a. (Not counting the day(s) missed from work missed from school, (and) in bed ). Was there any (OTHER) time during those 2 weeks that -- cut down on the things -- usually does because of illness or injury?

b. (Again, not counting the day(s) missed from work, missed from school, (and) in bed)
During that period, how many (OTHER) days did -- cut down for more than half of the day because of illness or injury?

This survey is being conducted to collect information on the Nation's health. I will ask about visits to doctors and dentists, illness in the family, and other health related items. (Hand calendar)

The next few questions refer to the past 2 weeks, the 2 weeks outlined in red on that calendar, beginning Monday (date) and ending this past Sunday (date).
5a. During those 2 weeks, did -- stay in bed because of any illness or injury?

b. During that 2-week period, how many days did -- stay in bed all or most of the day?

6. During those 2 weeks, how many days did illness or injury keep -- from work?
(For females): not counting work around the house?

7. During those 2 weeks, how many days did illness or injury keep -- from school?

This survey is being conducted to collect information on the Nation's health. I will ask about visits to doctors and dentists, illness in the family, and other health related items. (Hand calendar)

The next few questions refer to the past 2 weeks, the 2 weeks outlined in red on that calendar, beginning Monday (date) and ending this past Sunday (date).
5a. During those 2 weeks, did -- stay in bed because of any illness or injury?

b. During that 2-week period, how many days did -- stay in bed all or most of the day?

6. During those 2 weeks, how many days did illness or injury keep -- from work?
(For females): not counting work around the house?

7. During those 2 weeks, how many days did illness or injury keep -- from school?

The next few questions refer to the past 2 weeks, the 2 weeks outlined in red on that calendar, beginning Monday, ____ (date), and ending this past Sunday, ____(date).

5 a. During those 2 weeks, did -- stay in bed because of any illness or injury?

b. During that 2-week period, how many days did -- stay in bed all or most of the day?

If age:

6. During those 2 weeks, how many days did illness or injury keep -- from work? (For females): not counting work around the house.

7. During those 2 weeks, how many days did illness or injury keep -- from school?

The next few questions refer to the past 2 weeks, the 2 weeks outlined in red on that calendar,
beginning Monday, (date), and ending this past Sunday, (date).

5a. During those 2 weeks, did -- stay in bed because of any illness or injury?

b. During that 2-week period, how many days did -- stay in bed all or most of the day?

6. During those 2 weeks, how many days did illness or injury keep -- from work? (For females): not counting work around the house.

7. During those 2 weeks, how many days did illness or injury keep -- from school?

If one or more days in 5b, ask 8; otherwise go to 9.

8. On how many of these -- days lost from

did -- stay in bed all or most of the day?

9a. NOT COUNTING the day(s)

Were there any (other) days during the past 2 weeks that -- cut down on the things he usually does because of illness or injury?

b. Again, not counting the day(s)

During that period, how many (other) days did he cut down for as much as a day?

The next few questions refer to the past 2 weeks, the 2 weeks outlined in red on that calendar,
beginning Monday, (date), and ending this past Sunday, (date).

5a. During those 2 weeks, did -- stay in bed because of any illness or injury?

b. During that 2-week period, how many days did -- stay in bed all or most of the day?

6. During those 2 weeks, how many days did illness or injury keep -- from work? (For females): not counting work around the house.

7. During those 2 weeks, how many days did illness or injury keep -- from school?

If one or more days in 5b, ask 8; otherwise go to 9.

8. On how many of these -- days lost from

did -- stay in bed all or most of the day?

9a. NOT COUNTING the day(s)

Were there any (other) days during the past 2 weeks that -- cut down on the things he usually does because of illness or injury?

b. Again, not counting the day(s)

During that period, how many (other) days did he cut down for as much as a day?

The next few questions refer to the past 2 weeks, the 2 weeks outlined in red on that calendar,
beginning Monday, (date), and ending this past Sunday, (date).

5a. During those 2 weeks, did -- stay in bed because of any illness or injury?

b. During that 2-week period, how many days did -- stay in bed all or most of the day?

6. During those 2 weeks, how many days did illness or injury keep -- from work? (For females): not counting work around the house.

7. During those 2 weeks, how many days did illness or injury keep -- from school?

If one or more days in 5b, ask 8; otherwise go to 9.

8. On how many of these -- days lost from

did -- stay in bed all or most of the day?

9a. NOT COUNTING the day(s)

Were there any (other) days during the past 2 weeks that -- cut down on the things he usually does because of illness or injury?

b. Again, not counting the day(s)

During that period, how many (other) days did he cut down for as much as a day?