Question

Name

qi_115

Label

115

Question Text

Can you tell me the name and address I asked you to remember a short while ago?

Instructions

Nurse enter the codes next to the words remembered. Code all that apply. Enter at most 6 values.

Type
Code List
Selection Style
SelectOne

Usage

356 questions before...

Nurse enter reason test not attempted.

Generic text

Can you tell me the name and address I asked you to remember a short while ago?

Nurse enter the codes next to the words remembered. Code all that apply. Enter at most 6 values.

1
John
2
Brown
3
42
4
West
5
Street
6
Bedford
7
None of the above
8
Refused

Nurse: Did the survey member have visual difficulty during testing?

1
No difficulty
2
Mild difficulty
3
Severe difficulty
4
No tests done
97 questions after...
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