By Anonymous - November 17, 2014

Baseline Page: A1

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Notes

* Version 2/3 add "aside from the flu" to the "Upper respiratory infection" response on question 3.

Images

Version 1 Version 2 Version 3
Baseline Questionnaire - Version 1 - Page A1 Baseline Questionnaire - Version 2 - Page A1 Baseline Questionnaire - Version 3 - Page A1

Variable List

Variable Name Description Notes
HEALTH
General Health
FLU
Influenza in prev. 12 months
URI
Upper respiratory infection
GASTRO
Gastroenteritis (stomach flu, food poisoning)
BRONCHIT
Bronchitis
CANCER
Ever diagnosed with cancer
CANCERA
Cancer A
CANCERB
Cancer B
CANCERC
Cancer C
CANCERAL
Cancer A Year write-in
CANCERBL
Cancer B Year write-in
CANCERCL
Cancer C Year write-in
CANCERAY
Cancer A Year bubbles
CANCERBY
Cancer B Year bubbles
CANCERCY
Cancer C Year bubbles