Questionnaire Text

Questionnaire form view entire document:  text  image
9. Does this house, apartment, or mobile home have COMPLETE plumbing facilities; that is, 1) hot and cold piped water, 2) a flush toilet, and 3) a bathtub or shower?

[ ] Yes, has all three facilities
[ ] No

Questionnaire instructions view entire document:  text  image
9.If you have all of the facilities listed, mark the "Yes, has all three facilities" box. All facilities must be in your house, apartment, or mobile home, but not necessarily in the same room. Consider that you have hot water even if you have it only part of the time. If any of the three facilities is not present, mark the "No" box.