Survey Text

2012
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2012
Survey form view entire document:  text  image
QuestionID: ALT.722_00.000

Instrument Variable Name: TP3_RS4 Adult CAM
QuestionText:
*Read if necessary. DURING THE PAST 12 MONTHS, did you {fill1: see a practitioner for/use} {fill2: modality} for any of these reasons? [fill3: Prescription medications/Over the counter medications/Prescription or over-the-counter medications] cause side effects?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: Sample adults 18+ who have used third of top three modalities and used prescription or over-the-counter medication to treat specific condition(s)
SkipInstructions:
(1,2,R,D) if self-care modality (ALT_TP33=6,7,10-16) [goto TP3_RS5]; else [goto TP3_RS6]

Survey form view entire document:  text  image
Question ID: CAL.722_00.000

Instrument Variable Name: CTP3RS4
QuestionText:
*Read if necessary. DURING THE PAST 12 MONTHS, did [fill S.C. name] [fill1: see a practitioner for/use] [fill2: modality] for any of these reasons? [fill3: Prescription medications/Over the counter medications/Prescription or over-the-counter medications] cause side effects?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: Sample children 4+ who have used third of top three modalities and used prescription or over-the-counter medication to treat specific condition(s)
SkipInstructions:
(1,2,R,D) if self-care modality (CAL_TP33=6,7,10-16) [goto CTP3RS5];
else [goto CTP3RS6]