| BOX_01
 IF ROUND 1 OR IF RESPONDENT FOR THIS ROUND IS NOT THE SAME AS THE RESPONDENT FOR THE PREVIOUS ROUND,
 GO TO CA01
 IF NOT ROUND 1 AND IF RESPONDENT FOR THIS ROUND IS SAME AS RESPONDENT FOR THE PREVIOUS ROUND,
 CONTINUE WITH BOX_02
 
 BOX_02
 
 IF NOT ROUND 1 AND RESPONDENT USED ANY CALENDAR DURING THE PREVIOUS ROUND’S INTERVIEW - CL67 IS
 CODED ‘1’ (YES) FOR USE OF MONTHLY PLANNER, HEALTH
 EVENTS WORKSHEET, RECORD FILE, OR OTHER CALENDAR,
 GO TO CA02
 OTHERWISE, CONTINUE WITH CA01  
 CA01
 
 The next questions are about health care received 
{since {START DATE
 OF REFERENCE PERIOD}/between {START DATE OF REFERENCE 
PERIOD} and {END
 DATE OF REFERENCE PERIOD}}. Some of these questions 
ask for information
 which may be difficult to remember. It is important to 
get complete and
 accurate information, so please take your time and 
feel free to refer to
 any records you may have.
 TYPES OF RECORDS THAT ARE HELPFUL (USE RECORDS JOB AID 
IN QUICK
 REFERENCE GUIDE AS NEEDED):
 
 - Any kind of calendar or electronic calendar that you 
regularly use to
 keep track of health care appointments. (If you wrote 
things down on
 the monthly planner we mailed you, we can use that.)
 
 - Any records that might help you remember health care 
received without
 an appointment, such as a health insurance statement, 
or a payment
 record like a credit card statement or checkbook log.
 
 ASK RESPONDENT TO GET RECORD KEEPING MATERIALS IF NOT 
ALREADY OUT.
 
 HAS MEPS RECORD KEEPING MATERIALS ..... 1 {CA03}
 HAS SOME OTHER TYPE OF RECORD KEEPING
 MATERIALS ............................. 2 {CA03}
 DOES NOT HAVE RECORDS ................. 3 {CA04}
 WILL NOT USE RECORDS .................. 4 {CA04}
 
 [Code One]
 
 DISPLAY ‘since {START DATE OF REFERENCE PERIOD}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE OF
 REFERENCE PERIOD} and {END DATE OF REFERENCE
 PERIOD}’ IF ROUND 5.
 
 FOR ‘START DATE OF REFERENCE PERIOD’, DISPLAY THE
 START DATE OF THE CURRENT INTERVIEW AS MM/DD/YYYY.
 FOR ‘END DATE OF REFERENCE PERIOD’, DISPLAY THE RU
 END DATE FOR ROUND 5 AS MM/DD/YYYY.
 
 CA02
 
 The next questions are about health care received 
{since {START
 DATE OF REFERENCE PERIOD}/between {START DATE OF 
REFERENCE PERIOD}
 and {END DATE OF REFERENCE PERIOD}}. As you may 
remember from the
 last interview, some of these questions ask for 
information which
 may be difficult to remember.
 
 TYPES OF RECORDS THAT ARE HELPFUL (USE RECORDS JOB AID 
IN QUICK
 REFERENCE GUIDE AS NEEDED):
 
 - Any kind of calendar or electronic calendar that you 
regularly use to
 keep track of health care appointments. (If you wrote 
things down on
 the monthly planner we mailed you, we can use that.)
 
 - Any records that might help you remember health care 
received without
 an appointment, such as a health insurance statement, 
or a payment
 record like a credit card statement or checkbook log.
 
 THANK RESPONDENT FOR USING RECORDS DURING THE PREVIOUS 
INTERVIEW.
 ASK RESPONDENT TO GET RECORD KEEPING MATERIALS IF NOT 
ALREADY OUT.
 
 HAS MEPS RECORD KEEPING MATERIALS...... 1 {CA03}
 HAS SOME OTHER TYPE OF RECORD KEEPING
 MATERIALS ............................. 2 {CA03}
 DOES NOT HAVE RECORDS ................. 3 {CA04}
 WILL NOT USE RECORDS .................. 4 {CA04}
 
 [Code One]
 
 DISPLAY ‘since {START DATE OF REFERENCE PERIOD}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE OF
 REFERENCE PERIOD} and {END DATE OF REFERENCE
 PERIOD}’ IF ROUND 5.
 
 FOR ‘START DATE OF REFERENCE PERIOD’, DISPLAY THE
 START DATE OF THE CURRENT INTERVIEW AS MM/DD/YYYY.
 FOR ‘END DATE OF REFERENCE PERIOD’, DISPLAY THE RU
 END DATE FOR ROUND 5 AS MM/DD/YYYY.
 
 CA03
 
 Has anyone in the family been keeping records of all visits to medical
 providers and medical places, most of the visits, only some of the
 visits, or have no records been kept?
 
 IF MORE THAN ONE PERSON IN RU: Do you have records 
that cover health
 care received for each person (in your family)?
 
 PROBE AS NEEDED TO ESTABLISH HOW WELL THE RESPONDENT’S 
RECORDS COVER THE
 HEALTH CARE VISITS FOR ALL FAMILY MEMBERS.
 
 ALL VISITS RECORDED .................... 1 {BOX_05}
 MOST VISITS RECORDED ................... 2 {BOX_05}
 SOME VISITS RECORDED ................... 3 {CA04}
 NO RECORDS KEPT......................... 4 {CA04}
 VOLUNTEERED: NO EVENTS TO RECORD ...... 5 {BOX_05}
 REF ................................... -7 {CA04}
 DK .................................... -8 {CA04}
 
 [Code One]
 
 THE COMPUTER SUMMARY ITEMS (BOX_03 – CA05) WERE REMOVED IN PANEL 12 ROUND 2. STARTING IN
 PANEL 13, THESE ITEMS WILL BE OMITTED IN ALL
 ROUNDS.
 
 CA04
 
 GIVE RESPONDENT A MONTHLY PLANNER (CALENDAR).
 
 Through the rest of the interview, there are questions 
that will ask for
 dates. When you do not remember the date, we can refer 
to this calendar
 for help.
 
 CIRCLE {TODAY'S DATE/12/31/{YEAR}} {AND DATE OF LAST 
INTERVIEW}.
 
 PRESS ENTER OR SELECT NEXT PAGE TO CONTINUE.
 
 DISPLAY ‘TODAY’S DATE’ IF NOT ROUND 5. DISPLAY ‘12/31/{YEAR}’ IF ROUND 5. FOR {YEAR} DISPLAY
 SECOND YEAR OF PANEL.
 
 Display ‘AND DATE OF LAST INTERVIEW’ if not
 ROUND 1. OTHERWISE, USE A NULL DISPLAY.
 THE COMPUTER SUMMARY ITEMS (BOX_03 – CA05) WERE REMOVED IN PANEL 12 ROUND 2. STARTING IN
 PANEL 13, THESE ITEMS WILL BE OMITTED IN ALL
 ROUNDS.
 GO TO BOX_05  
 BOX_03
 
 OMITTED.
 
 BOX_04
 
 OMITTED.
 
 CA05
 
 OMITTED.
 
 BOX_05
 
 GO TO NEXT QUESTIONNAIRE SECTION  
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