Return to round 5 questionnaire table of contents
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IF THE INFORMATION BELOW IS CORRECT.ENTER ANY NEW CONTACT INFORMATION INTO THE APPROPRIATE FIELDS.IF OLD INFORMATION IS NO LONGER VALID AND NO NEW INFORMATION IS AVAILABLE, DELETE THE ENTRY AND LEAVE IT BLANK.IF THE RESPONDENT DOES NOT HAVE A PIECE OF CONTACT INFORMATION, LEAVE THE ENTRY FIELD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.