Questionnaire Text

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14 Do you have any of the following long-lasting conditions?

a) Blindness, deafness or a severe vision or hearing impairment?
[] 1 Yes
[] 2 No

b) A condition that substantially limits one or more basic physical activities such as walking, climbing stairs, reaching, lifting or carrying?
[] 1 Yes
[] 2 No
Questionnaire instructions view entire document:  text  image
14. Do you have any of the following long-lasting conditions:

(a) Blindness, deafness or a severe vision or hearing impairment?
[] 1Yes
[] 2 No

(b) A condition that substantially limits one or more basic physical activities such as walking, climbing stairs, reaching, lifting or carrying?
[] 1 Yes
[] 2 No