Questionnaire Text

Questionnaire form view entire document:  text  image

F1. Ask these questions to all persons.


28. Does the person have any of these limitations?

[] 1 Blindness
[] 1 Loss of hearing
[] 1 Mute
[] 1 Retardation or mental deficiency
[] 1 Paralysis or missing upper appendages
[] 1 Paralysis or missing lower appendages
[] 2 None of the above limitations


[Numbering shown as appears in the original language form]
Questionnaire instructions view entire document:  text  image

F1. Ask these questions to all persons


28. Does [the respondent] have any of these limitations?

The objective of this question is to determine the number of persons with permanent limitations in the functioning of their sensory, locomotive, and mental organs.

[Below the text is a form.]

Read each of the alternatives and mark all those that in which the interviewed person answers affirmatively.

If a person answers that they have no limitations or mention something that is not included in the list, mark "none of the previous".

The option "paralysis or absence of superior members" is marked when a person is missing fingers or has lost movement of them. Also when the problem affects the hand completely, the arm or the forearm. In a similar manner, "paralysis or absence of inferior members" when the members affected are the feet or legs.