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2015

Survey form view entire document: text image

Question ID: NAF.050_01.000

Instrument Variable Name: RSKX1_MT
Question Text:

1 of 2
When did you have your MOST RECENT skin exam to check for cancer?
*Enter month of last skin exam.
* Enter '96' to go to the number and time period format.

01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
96 Time period format
97 Refused
99 Don't know

Universe Text: Sample adults 18+ who have had a skin exam
Skip Instructions:

(1-12,D) [go to RSKX1_YR]
(R) store "R' in RSKX1_YR [go to RSKX2]
(96) store "9996" in RSKX1_YR [go to RSKX1N]

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2010

Survey form view entire document: text image

Question ID: NAF.050_01.000

Instrument Variable Name: RSKX1_MT
QuestionText:

1 of 2
When did you have your MOST RECENT skin exam to check for cancer?
*Enter month of last skin exam.
* Enter '96' to go to the number and time period format.

01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
96 Time period format
97 Refused
99 Don't know

UniverseText: Sample adults 18+ who have had a skin exam
SkipInstructions:

(1-12,D) [goto RSKX1_YR]
(R) store "R' in RSKX1_YR [goto RSKX2]
(96) store "9996" in RSKX1_YR [goto RSKX1N]

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2005

Survey form view entire document: text image

NAF.050_01.000

Instrument Variable Name: RSKX1_MT
Question Text:

1 of 2
When did you have your MOST RECENT skin exam to check for cancer?
*Enter month of last skin exam.
*Enter '96' to go to the number and time period format.

01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
96 Time period format
97 Refused
99 Don't know

Universe Text: Sample adults 18+ who have had a skin exam
Skip Instructions:

(1-12,D) [goto RSKX1_YR] (R) store "R' in RSKX1_YR [goto RSKX2] (96) store "96" in RSKX1_YR [goto RSKX1N]

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2000

Survey form view entire document: text image

NAF.050-055

When did you have your MOST RECENT skin exam?

FR: ENTER "T" TO USE TIME PERIOD FORMAT.

NAF.050

Month:

RSKX1_MT

(01) January
(02) February
(03) March
(04) April
(05) May
(06) June
(07) July
(08) August
(09) September
(10) October
(11) November
(12) December
(97) Don't know
(99) Refused
(T) Time Period (NAF.055)

Year:

RSKX1_YR

(1950-2000) 1950-2000 (NAF.070)
(9997) Don't know (NAF.060)
(9999) Refused (NAF.060)

NAF.055

[ ] NUMBER

RSKX1_NO

(01-94) 1-94 (RSKX1_TP/NAF.055)
(95)95+ (RSKX1_TP/NAF.055)
(97)Refused (NAF.060)
(99)Don't know (NAF.060)

[ ] TIME PERIOD

RSKX1_TP

(1) Days ago
(2) Weeks ago
(3) Months ago
(4) Years ago
(7) Refused
(9) Don't know

[Go to NAF.070]

NAF.060

FR: SHOW CARD CAN17

Was it: (READ CATEGORIES BELOW)

Card CAN17

1. A year ago or less
2. More than 1 year but not more than 2 years
3. More than 2 years but not more than 3 years
4. More than 3 years but not more than 5 years
5. Over 5 years ago

RSKX2

(1) ... a year ago or less?
(2) ... more than 1 year but not more than 2 years?
(3) ... more than 2 years but not more than 3 years?
(4) ... more than 3 years but not more than 5 years?
(5) ... over 5 years ago?
(7) Refused
(9) Don't know

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1992

Survey form view entire document: text image

7a. When did you have your most recent skin exam?

Month ____ [if 3 years ago or less (8); if more than 3 years ago (10)]
Year 19____ [if 3 years ago or less (8); if more than 3 years ago (10)]
OR

Number ____

1[] Days ago [if 3 years ago or less (8); if more than 3 years ago (10)]
2[] Weeks ago [if 3 years ago or less (8); if more than 3 years ago (10)]
3[] Months ago [if 3 years ago or less (8); if more than 3 years ago (10)]
4[] Years ago [if 3 years ago or less (8); if more than 3 years ago (10)]

999[] DK (7b)

Survey Text