Questionnaire Text

Questionnaire form view entire document:  text  image
Special Group Population
15. Is any member of the household disabled in any way?
[] Yes (fill in Disability Supplement)
[] No
Questionnaire instructions view entire document:  text  image
5.4 Disability

You are about to start a rather sensitive topic. Prepare the respondent by telling him/her that you are now going to start asking questions on disability.
A person with a disability is defined as a person who is limited in the kind or amount of activities that he or she can do because of the ongoing difficulties due to a long term physical condition, mental condition or health problem. Short term disabilities due to temporary conditions such as broken legs and illness are excluded. Only disabilities lasting for more than six months should be included.

P15 Are You Disabled in any Way?
Find out whether this person is disabled and shade appropriately. If the respondent is not disabled, skip to P18.