Questionnaire Text

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4.23 Prior Brazilian state or foreign country of residence
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Question 4.10 - Do you have any type of permanent mental deficiency that limits your regular activities? (such as work, going to school, playing, etc.)

Mark, as the case may be:

1 - Yes - If the existence of permanent mental deficiency is confirmed, except for mental disease, which prevents the person from exercising his or her routine activities, such as working, going to school, playing, performing domestic chores, etc.
2 - No - Do not consider mental disturbances or mental disease, such as autism, neurosis, schizophrenia or psychosis, as mental deficiency.


Note: In general, mental deficiency is first seen in childhood or up to the age of 18.