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PDF, 3.8 MB - Substance Abuse and Mental Health Services ...

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NORES3C2<<br />

>C1A<<br />

I was given this telephone number to verify that our interviewer made contact with<br />

someone that either lives at or is knowledgeable about (address). Are you familiar with<br />

(address) or with our interviewer who is (FI description)<strong>and</strong> would have asked questions<br />

such as how many people live in this household, their ages <strong>and</strong> race?<br />

YES [C1A]<br />

NO [DONEC]<br />

DON’T KNOW [DONEC]<br />

REFUSE [DONEC]<br />

Thinking of (address), were all occupants between the ages of 17- 65 on active military<br />

duty during recent weeks?<br />

YES [C1D]<br />

NO [C1B]<br />

DON’T KNOW [C1C]<br />

REFUSED [C1C]<br />

>C1B<<br />

Let me verify, were all household members between the ages if 17-65 who were living at<br />

(address) on or around (Screening Date) on active military duty?<br />

YES [C1D]<br />

NO [C1D]<br />

DON’T KNOW<br />

REFUSED [C1C]<br />

[C1C]<br />

>C1C<<br />

To the best of your knowledge, (were/was)<br />

(Roster Data)<br />

on active military duty on or around (Screening Date)?<br />

YES [C1D]<br />

NO [C1D]<br />

DON’T KNOW<br />

REFUSED [CID]<br />

[C1D]<br />

E-23

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