Survey Text

2000
1992
top
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

top
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)

b. Was it within the past year, between 1 and 3 years ago, or over 3 years ago?

1[] Within the past year (8)
2[] 1 to 3 years ago (8)
3[] Over 3 years ago (10)
9[] DK (10)