ca004s1
General information
Question text: | Which of the following conditions or disabilities, if any, apply to the person you are helping to care for? Please check all that apply, or write in an answer if it is not in the list below. |
Answer type: | Check boxes |
Answer options: | 1 Alzheimer's disease, other dementia or cognitive impairment 2 Cancer 3 Stroke 4 Intellectual or developmental disability 5 Physical disability or injury 6 Mental health or psychiatric disability 7 Diabetes 8 Heart disease 9 Other chronic illness 10 Vision impairment, blindness 11 Other age-related impairments 12 Other (please write in): ~ca004_other 13 None |
Label: | which conditionds or disabilities |
Empty allowed: | One-time warning |
Error allowed: | Not allowed |
Multiple instances: | No |