Questionnaire Text

Questionnaire form view entire document:  text  image
33. What time did this person usually leave home to go to work LAST WEEK?
Hour Minute
[ ][ ]:[ ][ ]

[ ] a.m.
[ ] p.m.
Questionnaire instructions view entire document:  text  image
33.Give the time of day the person usually left home to go to work. DO NOT give the time that the person usually began his or her work.

If the person usually left home to go to work sometime between 12:00 o'clock midnight and 12:00 o'clock noon, mark a.m.

If the person usually left home to go to work sometime between 12:00 o'clock noon and 12:00 o'clock midnight, mark p.m.