Question

Name

qi_111

Label

111

Question Text

Later on I am going to give you a name and address to write on this envelope. When you have finished doing that I would like you to do the following: Turn it over, seal it, and write your initials on the back. Could you remember to do that then, without me reminding you?

Instructions

Nurse: Hold up blank envelope. Nurse: Now put the envelope out of sight.

Type
Code List
Selection Style
SelectOne

Usage

351 questions before...

Nurse: Please record why fourth word list trial was not attempted.

Generic text

Later on I am going to give you a name and address to write on this envelope. When you have finished doing that I would like you to do the following: Turn it over, seal it, and write your initials on the back. Could you remember to do that then, without me reminding you?

Nurse: Hold up blank envelope. Nurse: Now put the envelope out of sight.

1
Respondent will do the test
2
Respondent refuses to do the test

Now I would like you to tell me the names of as many different animals as you can in one minute? Animals are everything that is not vegetable or mineral.

If asks for clarification: animals include birds, insects, humans, etc. Set the stop watch for one minute and write down the animals on page 8 of the paper test booklet.

1
Respondent will do the test
2
Respondent refuses to do the test
102 questions after...
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