Now I'd like to ask you some questions about [youth.name()]'s general state of health.

In general, how is [youth.his/her()] health?

(Excluding pregnancy), does [youth.name()] have or has [youth.he/she()] ever had any physical, emotional, or mental condition that limits or has limited [youth.his/her()] ability to attend school regularly, do regular school work, or work at a job for pay?

Does [youth.name()] regularly take any medicine or prescription drugs related to a chronic condition?

Does [youth.name()] now have or has [youth.he/she()] ever had a learning or emotional problem that limits or has limited the kind of schoolwork or other daily activities [youth.he/she()] can perform, the amount of time [youth.he/she()] can spend on these activities or [youth.his/her()] performance in these activities?

([PC9-002()] = 1) OR ([PC9-004()] = 1)

COMMENT: was yes answered to either question 2 or 4?

What (is/are) the condition(s)?


(SELECT ALL THAT APPLY.)

REPEAT ([{PC9-LOOP-1}])

COMMENT: go through conditions selected

INLIST ([PC9-006([{pc-loop}])],[{pc9-loop-1}])

COMMENT: was this choice selected?

How old was [youth.name([{pc-loop}])] when the [pc9-textsub-1()] was first noticed?


(INTERVIEWER: ENTER "0" IF [youth.name([{pc-loop}])] HAS HAD THIS
CONDITION SINCE BIRTH.)

Does the [pc9-textsub-1()] currently limit [youth.name([{pc-loop}])]?

UNTIL ([{pc9-loop-1}], ([{pc9-loop-1}] = 5))

COMMENT: repeat loops until all selections checked

Does [youth.name()] now have or has [youth.he/she()] ever had trouble seeing, hearing or speaking?

What (is/are) the condition(s)?


(SELECT ALL THAT APPLY.)

REPEAT ([{PC9-LOOP-2}])

COMMENT: loop through the conditions selected

INLIST ([PC9-015([{pc-loop}])],[{pc9-loop-2}])

COMMENT: was this condition selected?

How old was [youth.name([{pc-loop}])] when the [pc9-textsub-2()] was first noticed?


(INTERVIEWER: ENTER "0" IF [youth.name([{pc-loop}])] HAS HAD THIS
CONDITION SINCE BIRTH.)

Does the [pc9-textsub-2()] currently limit [youth.name([{pc-loop}])]?

UNTIL ([{pc9-loop-2}], ([{pc9-loop-2}] = 7))

COMMENT: repeat loops until all selections checked

Does [youth.name()] now have or has [youth.he/she()] ever had a part of [youth.his/her()] body that (is/was) deformed or missing?

What (is/are) the condition(s)?


(SELECT ALL THAT APPLY.)

REPEAT ([{PC9-LOOP-3}])

COMMENT: loop through conditions selected

INLIST ([PC9-024([{pc-loop}])],[{pc9-loop-3}])

COMMENT: was this condition selected?

How old was [youth.name([{pc-loop}])] when the [pc9-textsub-3()] was first noticed?


(INTERVIEWER: ENTER "0" IF [youth.name([{pc-loop}])] HAS HAD THIS
CONDITION SINCE BIRTH.)

Does the [pc9-textsub-3()] currently limit [youth.name([{pc-loop}])]?

UNTIL ([{pc9-loop-3}], ([{pc9-loop-3}] = 4))

COMMENT: repeat loops until all selections checked

Does [youth.name()] now have or has [youth.he/she()] ever had any other chronic health condition or life threatening disease such as asthma, heart condition, anemia, diabetes or cancer?

What (is/are) the condition(s)?


(SELECT ALL THAT APPLY.)

REPEAT ([{PC9-LOOP-4}])

COMMENT: loop through conditions selected

INLIST ([PC9-033([{pc-loop}])],[{pc9-loop-4}])

COMMENT: was this condition selected?

How old was [youth.name([{pc-loop}])] when the [pc9-textsub-4()] was first noticed?


(INTERVIEWER: ENTER "0" IF [youth.name([{pc-loop}])] HAS HAD THIS
CONDITION SINCE BIRTH.)

Does the [pc9-textsub-4()] currently limit [youth.name([{pc-loop}])]?

UNTIL ([{pc9-loop-4}], ([{pc9-loop-4}] = 6))

COMMENT: repeat loops until all selections checked

(HAND CARD L)

Is [youth.name()] covered by health insurance that includes physician or hospital care through any of the following?