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2022 ACS

Questionnaire form view entire document: text image

b) Is this person blind or does he/she have serious difficulty seeing even when wearing glasses?

[ ] Yes
[ ] No

[G] - Answer question 18a-c if this person is 5 years old or over. Otherwise, SKIP to the questions for PERSON 2 on page 12.

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2021 ACS

Questionnaire form view entire document: text image

b) Is this person blind or does he/she have serious difficulty seeing even when wearing glasses?

[ ] Yes
[ ] No

[G] - Answer question 18a-c if this person is 5 years old or over. Otherwise, SKIP to the questions for PERSON 2 on page 12.

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2016 ACS

Questionnaire form view entire document: text image

b) Is this person blind or does he/she have serious difficulty seeing even when wearing glasses?

[ ] Yes
[ ] No

[G] - Answer question 18a-c if this person is 5 years old or over. Otherwise, SKIP to the questions for PERSON 2 on page 12.

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2011 ACS

Questionnaire form view entire document: text image

b) Is this person blind or does he/she have serious difficulty seeing even when wearing glasses?

[ ] Yes
[ ] No

[G] - Answer question 18a-c if this person is 5 years old or over. Otherwise, SKIP to the questions for PERSON 2 on page 12.

Questionnaire Text