|
|
|
Start of EM. Major Events
|
| |
M1
Did you move to another address?
DID YOU MOVE TO ANOTHER ADDRESS?
1 Yes ____
2 No
8 RF
9 DK
|
| |
M2
Did you reside in different cities?
DID YOU RESIDE IN DIFFERENT CITIES?
1 Yes ___
2 No
8 RF
9 DK
|
| |
M3
Did you reside sometime in the US?
DID YOU RESIDE SOMETIME IN THE US?
1 Yes ___
2 No
8 RF
9 DK
|
| |
M4
Did you have a stroke?
DID YOU HAVE A STROKE?
1 Yes ____
2 No
8 RF
9 DK
|
| |
M5
Did you have a heart attack?
DID YOU HAVE A HEART ATTACK?
1 Yes ___
2 No
8 RF
9 DK
|
| |
M6
Did you have a major surgery?
DID YOU HAVE A MAJOR SURGERY?
1 Yes ___
2 No
8 RF
9 DK
|
| |
M7
Have you been hospitalized for another reason?
HAVE YOU BEEN HOSPITALIZED FOR ANOTHER REASON?
1 Yes ___
2 No
8 RF
9 DK
|
| |
M8
Have you been diagnosed with a new cancer?
HAVE YOU BEEN DIAGNOSED WITH A NEW CANCER?
1 Yes ___
2 No
8 RF
9 DK
|
| |
M9
A disaster occurred (hurricane, earthquake, tornado, flooding, fire) that damaged your home?
A DISASTER OCCURRED (HURRICANE, EARTHQUAKE,
TORNADO, FLOODING, FIRE) THAT DAMAGED YOUR HOME?
1 Yes ___
2 No
8 RF
9 DK
|
| |
M10
Did you have an accident, victim of a crime, or any other event that affected your health or familY situation?
DID YOU HAVE AN ACCIDENT, VICTIM OF A CRIME, OR ANY
OTHER EVENT THAT AFFECTED YOUR HEALTH OR FAMILY
SITUATION?
1 Yes ___
2 No
8 RF
9 DK
|
| |
|
End of EM. Major Events
|
