OMB No. 0925-0530
Exp. Date 06/30/07
<<Note: NCCAM’s intention is to contribute to, not to create, omnibus surveys. One or two NCCAM questions would appear on a survey containing several other questions and from several other organizations. Below are two sample questions that NCCAM might include in an omnibus survey.>>
Have you been diagnosed with diabetes?
Yes
No
Don’t know
Refused
If “yes”:
Do you take vitamins, herbal supplements, or other dietary supplements?
Yes
No
Don’t know
Refused
| File Type | application/msword |
| File Title | SAMPLE: QUESTIONS FOR OMNIBUS SURVEY |
| Author | sniemeyer |
| Last Modified By | Suzanne Niemeyer |
| File Modified | 2007-06-15 |
| File Created | 2007-06-14 |