Questionnaire Text

Questionnaire form view entire document: text image

For all persons
[Applies to questions 1-8]

8. What kind of insurance do you have? (Read each option and circle one or more numbers)

[] 1 Comprehensive health insurance [Sis] sponsored by the Government and targeted to poor and low income people
[] 2 Government health plan for all employed workers and people receiving retirement income [Essalud]
[] 3 Other health insurance
[] 4 None

Questionnaire instructions view entire document: text image

For All People
[Applies to questions 1-8]

Question 8: What kind of insurance do you have?
If the respondent has health insurance from the armed forces, police, or a private insurer, circle option 3, "Other health insurance."
If the respondent does not have any health insurance, circle option 4, "None." Remember that this option should not be read out loud.
Example: Aurelia only has the PNP health insurance because her husband is the head of the National Police Force. In this case, circle option 3, "Other health insurance."
[Next to the text there is a graphic reproducing box 8, correctly filled out in accordance with the example.]