Questionnaire Text

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11. a. Does this person speak a language other than English at home?
[] Yes
[] No --> Skip to 12
b. What is this language?
[ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ]
(For example: Korean, Italian, Spanish, Vietnamese)
c. How well does this person speak English?
[] Very well
[] Well
[] Not well
[] Not at all