C-HL1. In the last 6 months, how often did this provider ask if you had any questions about your health?
1 ☐ Never
2 ☐ Sometimes
3 ☐ Usually
4 ☐ Always
|
After core question 10
|
C-HL2. In the last 6 months, how often did this provider use medical words you did not understand?
1 ☐ Never
2 ☐ Sometimes
3 ☐ Usually
4 ☐ Always
|
After core question 11
|
C-HL3. In the last 6 months, how often did this provider talk too fast when talking with you?
1 ☐Never
2 ☐Sometimes
3 ☐Usually
4 ☐Always
|
After C-HL2
|
C-HL4. In the last 6 months, how often did this provider talk with you about the reasons for your visit?
1 ☐ Yes
2 ☐ No
|
After core question 12
|
C-HL5. In the last 6 months, did you talk with this provider about any health questions or concerns?
1 ☐ Yes
2 ☐ No → If No, go to HL9
|
After C-HL4
|
C-HL6. In the last 6 months, how often did this provider show interest in your questions or concerns?
1 ☐ Never
2 ☐ Sometimes
3 ☐ Usually
4 ☐ Always
|
After C-HL5
Note: Use with C-HL5
|
C-HL7. In the last 6 months, how often did this provider give you easy to understand information about these health questions or concerns?
1 ☐Never
2 ☐ Sometimes
3 ☐ Usually
4 ☐ Always
|
After C-HL6
Note: Use with C-HL5
|
C-HL8. In the last 6 months, how often did this provider answer all of your questions?
1 ☐Never
2 ☐ Sometimes
3 ☐ Usually
4 ☐ Always
|
After C-HL7
|
C-HL9. In the last 6 months, how often did this provider give you all the information you wanted about your health?
1 ☐ Never
2 ☐ Sometimes
3 ☐ Usually
4 ☐ Always
|
After C-HL8
|
C-HL10. In the last 6 months, did you see this provider for a specific illness or for any health condition?
1 ☐ Yes
2 ☐ No → If No, go to core question 14
|
After core question 13
|
C-HL11. In the last 6 months, did this provider give you instructions about what to do to take care of this illness or health condition?
1 ☐ Yes
2 ☐ No → If No, go to core question 14
|
After C-HL10
Note: Use with C-HL10 |
C-HL12. In the last 6 months, how often were these instructions easy to understand?
1 ☐ Never
2 ☐ Sometimes
3 ☐ Usually
4 ☐ Always
|
After C-HL11
Note: Use with C-HL10 and C-HL11
|
C-HL13. In the last 6 months, how often did this provider ask you to describe how you were going to follow these instructions?
1 ☐ Never
2 ☐ Sometimes
3 ☐ Usually
4 ☐ Always
|
After C-HL12
Note: Use with C-HL10 and C-HL11
|
C-HL14. In the last 6 months, did you start a prescription medicine?
1 ☐ Yes
2 ☐ No → If No, go to core question 16
|
After core question 15
|
C-HL15. In the last 6 months, how often did this provider give you easy to understand instructions about how to take your medicines?
1 ☐ Never
2 ☐ Sometimes
3 ☐ Usually
4 ☐ Always
|
After C-HL14
Note: Use with C-HL14
|
C-HL16. In the last 6 months, how often did this provider explain the possible side effects of your medicines in a way that was easy to understand?
1 ☐ Never
2 ☐ Sometimes
3 ☐ Usually
4 ☐ Always
|
After C-HL15
Note: Use with C-HL14 |
C-HL17. In the last 6 months, how often did this provider suggest ways to help you remember to take your medicines?
1 ☐ Never
2 ☐ Sometimes
3 ☐ Usually
4 ☐ Always
|
After C-HL16
Note: Use with C-HL14 |
C-HL18. In the last 6 months, before you had a blood test, x-ray, or other test, how often did this provider explain what it was for?
1 ☐ Never → If Never, go to core question 17
2 ☐ Sometimes
3 ☐ Usually
4 ☐ Always
|
After core question 16
Note: Use with C-HL14 |
C-HL19. In the last 6 months, how often was the explanation of what the test was for easy to understand?
1 ☐ Never
2 ☐ Sometimes
3 ☐ Usually
4 ☐ Always
|
After C-HL18
Note: Use with C-HL18 |
C-HL20. In the last 6 months, how often were the results of your blood test, x-ray, or other test easy to understand?
1 ☐ Never
2 ☐ Sometimes
3 ☐ Usually
4 ☐ Always
|
After core question 17
|