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That's all the survey questions I have, but now I need to get some information to help us contact you in the future. And again, this information, like your responses to all questions in the interview, is confidential.
I have your home address as [street address line 1] [street address line 2] [city] [state] [zip code]. Is that correct?
What is your current home address?
Is your mailing address the same as your home address?
What is your mailing address?
([phone number]= " -4")COMMENT: R's phone number is missing from DLI
We have your home telephone number as [phone number]. Is this correct?
Is there a telephone at your house?
What is your correct telephone number, including area code?(INTERVIEWER: PLEASE USE THE COMMENT BOX WHEN ENTERING A FOREIGN TELEPHONE NUMBER)
Is this telephone number listed in your name? (INTERVIEWER: IS TELEPHONE LISTED IN MOTHER'S OR FATHER'S NAME AND R RESIDES IN SAME HOUSEHOLD)
In whose name is the telephone number listed?
Is there another telephone number at your home?
What is that telephone number?
In whose name is that number listed?
Do you have an e-mail address or a cell phone, pager, or FAX number where you can be reached?
INTERVIEWER: CONFIRM IF THE INFORMATION BELOW IS CORRECT.ENTER ANY NEW CONTACT INFORMATION INTO THE APPROPRIATE FIELDS.IF OLD INFORMATION IS NO LONGER VALID AND NO NEW INFORMATION IS AVAILABLE, DELETE THE ENTRY AND LEAVE IT BLANK.IF THE RESPONDENT DOES NOT HAVE A PIECE OF CONTACT INFORMATION, LEAVE THE ENTRY FIELD BLANK.
([R is currently employed]=1)COMMENT: R is currently employed
May we contact you at work if we are unable to locate you in the future?
What is your company''s name, address, and telephone number at work?
What is your telephone number at work?
Do you expect to move within the next year?
Where?
When do you think you might move?
In case we have difficulty getting in touch with you in the future, it would be helpful if we had some information about how to contact people who will always know your whereabouts.
([R's biological mother is alive]=1)COMMENT: R's biological mother is living
We have the following information listed for your mother. Is this information complete and correct? INTERVIEWER: SHOW THE RESPONDENT THE INFORMATION ON THE SCREEN BELOW.First name: [mother's first name] Middle name: [mother's middle name] Last name: [mother's last name] Nickname: [mother's nickname]Street address line 1: [address]Street address line 2: [address]Apartment: [apartment number]City: [city] State: [state] Zip: [zip code] State/Province: [state/province] Postal Code: [post code]Country: [country]Home Phone: [home phone number]Work Phone: [work phone number]Cell Phone: [cell phone number] Pager: [pager number]Fax: [fax number]E-Mail 1: [email address]E-Mail 2: [email address]
INTERVIEWER: INSERT THE CORRECT AND/OR COMPLETE INFORMATION FOR MOTHER BELOW AND ON THE FOLLOWING SCREEN.
INTERVIEWER: INSERT THE CORRECT AND/OR COMPLETE INFORMATION FOR MOTHER BELOW.
([R's biological father is alive]=1)COMMENT: R's biological father is living
We have the following information listed for your father. Is this information complete and correct? INTERVIEWER: SHOW THE RESPONDENT THE INFORMATION ON THE SCREEN BELOW.First name: [father's first name] Middle name: [father's middle name] Last name: [father's last name] Nickname: [father's nickname]Street address line 1: [address]Street address line 2: [address]Apartment: [apartment number]City: [city] State: [state] Zip: [zip code] State/Province: [state/province] Postal Code: [post code]Country: [country]Home Phone: [home phone number]Work Phone: [work phone number]Cell Phone: [cell phone number] Pager: [pager number]Fax: [fax number]E-Mail 1: [email address]E-Mail 2: [email address]
INTERVIEWER: INSERT THE CORRECT AND/OR COMPLETE INFORMATION FOR FATHER BELOW AND ON THE FOLLOWING SCREEN.
INTERVIEWER: INSERT THE CORRECT AND/OR COMPLETE INFORMATION FOR FATHER BELOW.
([goodcontact1]=1)COMMENT: we have contact information for person 1
We have [(first name)] [(last name)] listed as someone who will always know your whereabouts and would be able to contact you in case we have difficulty getting in touch with you in the future. Would this person still be able to contact you?
([goodcontact2]=1)COMMENT: we have contact information for person 2
([goodcontact3]=1)COMMENT: we have contact information for person 3
([good contact reference]=1)COMMENT: contact 1 is still a good contact person
We have the following information listed for [(first name)] [(last name)]. Is this information complete and correct? INTERVIEWER: SHOW THE RESPONDENT THE INFORMATION ON THE SCREEN BELOW.First name: [(first name)] Middle name: [middle name] Last name: [(last name)] Nickname: [nickname]Relationship: [relationship to R]Street address line 1: [address]Street address line 2: [address]Apartment: [apt. number]City: [city] State: [state] Zip: [zip] State/Province: [state/province] Postal Code: [post code]Country: [country]Home Phone: [home phone number]Work Phone: [work phone number]Cell Phone: [cell phone number] Pager: [pager number]Fax: [fax number]E-Mail 1: [email address]E-Mail 2: [email address]
INTERVIEWER: INSERT THE CORRECT AND/OR COMPLETE INFORMATION FOR [(first name)] [(last name)] BELOW AND ON THE FOLLOWING SCREEN.
INTERVIEWER: INSERT THE CORRECT AND/OR COMPLETE INFORMATION FOR [(first name)] [(last name)] BELOW.
([good contact reference]=1)COMMENT: contact 2 is still a good contact person
([good contact reference]=1)COMMENT: contact 3 is still a good contact person
We have the following information listed for [(first name)] [(last name)]. Is this information complete and correct? INTERVIEWER: SHOW THE RESPONDENT THE INFORMATION ON THE SCREEN BELOW.First name: [(first name)] Middle name: [middle name] Last name: [(last name)] Nickname: [nickname]Relationship: [relationship to R]Street address line 1: [address]Street address line 2: [address]Apartment: [apt. number]City: [city] State: [state] Zip: [zip] State/Province: [state/province] Postal Code: [post code]Country: [country]Home Phone: [home phone number]Work Phone: [work phone]Cell Phone: [cell phone number] Pager: [pager number]Fax: [fax number]E-Mail 1: [email address]E-Mail 2: [email address]
([good contact reference] + [good contact reference] + [good contact reference])
In case we have difficulty getting in touch with you in the future, could you give me the name, address, telephone number, FAX number, and e-mail address of three people who will always know your whereabouts? Please give me information for someone who does not live with you and is not your parent.
What is the name, address, phone, fax, cell phone, pager number, and e-mail address of the first person who would be able to contact you? INTERVIEWER: INSERT THIS INFORMATION BELOW AND ON THE FOLLOWING SCREEN.
INTERVIEWER: INSERT THE INFORMATION BELOW.
What is [first name]'s relationship to you?
What is the name, address, phone, fax, cell phone, pager number, and e-mail address of the second person who would be able to contact you? INTERVIEWER: INSERT THIS INFORMATION BELOW AND ON THE FOLLOWING SCREEN.
What is the name, address, phone, fax, cell phone, pager number, and e-mail address of the third person who would be able to contact you? INTERVIEWER: INSERT THIS INFORMATION BELOW AND ON THE FOLLOWING SCREEN.
And who else will always know your whereabouts? Please tell me about another person who doesn't live with you but might help us get in touch with you in the future. INTERVIEWER: PROBE FOR A LOCATING CONTACT WHO DOES NOT LIVE WITH THE FIRST LOCATING CONTACT OR WITH R.
What is the name, address, phone, fax, cell phone, pager number, and e-mail address of this person who would be able to contact you?INTERVIEWER: INSERT THIS INFORMATION BELOW AND ON THE FOLLOWING SCREEN.
What is the name, address, phone, fax, cell phone, pager number, and e-mail address of this person who would be able to contact you? INTERVIEWER: INSERT THIS INFORMATION BELOW AND ON THE FOLLOWING SCREEN.
Now I would like to make sure that we have the correct spelling of your name. Is this how you spell your name? INTERVIEWER: SPELL NAME TO THE RESPONDENT. IF SPELLING IS INCORRECT, CORRECT THE SPELLING ON THIS SCREEN.
Do you have a nickname, streetname, or some name other than your legal one by which most of your friends, neighbors, or relatives know you?
What is your nickname?
May we have your Social Security Number? We often find it useful when trying to locate people for their next interview.
Do you have a driver's license?
What is your driver''s license number?
Thank you for providing all of this information. You have been very helpful.
R's apartment number.
City where R currently lives.
State where R currently lives.
R's zip code.
Enter the middle name of the first additional contact.
Enter the last name of the first additional contact.
Enter the nickname of the first additional contact.
Enter line 1 of the street address of the first additional contact.
Enter line 2 of the street address of the first additional contact.
Enter the apartment number of the first additional contact.
Enter the city of the first additional contact.
Enter the state of the first additional contact.
Enter the zip code of the first additional contact.
Enter the foreign state/province of the first additional contact.
Enter the foreign postal code of the first additional contact.
Enter the country of the first additional contact.
Enter the area code of the first additional contact's home telephone number.
Enter the exchange of the first additional contact's home telephone number.
Enter the suffix of the first additional contact's home telephone number.
Enter the area code of the first additional contact's work telephone number.
Enter the exchange of the first additional contact's work telephone number.
Enter the suffix of the first additional contact's work telephone number.
Enter the area code of the first additional contact's cell telephone number.
Enter the exchange of the first additional contact's cell telephone number.
Enter the suffix of the first additional contact's cell telephone number.
Enter the area code of the first additional contact's fax number.
Enter the exchange of the first additional contact's fax number.
Enter the suffix of the first additional contact's fax number.
Enter the first additional contact's first email address.
Enter the first additional contact's second email address.
Enter the first name of the second additional contact.
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