Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)

IR1

IR1

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

IR_CASEOK

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

10

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:
Question display:

Display current round number.
If Proxy was respondent, display "(PROXY NAME) for (SP)".
Else display "(SP)".
Display the date the interview was complete, MRES.MRESEDAT, in
"MONTH DAY, YYYY" format.

Multi Field display:

Roster/Grid Instructions:
Roster/Grid display:
Report display:

TEXT:
Context Header:
Int. Instr I:

THE ROUND (CURRENT ROUND) COMMUNITY INTERVIEW FOR
(SP) WAS CONDUCTED WITH [(SP)/(PROXY NAME) FOR (SP)]
ON (INTERVIEW COMPLETION DATE). IS THIS THE CASE YOU
WANTED?

Question Text:

4:38:44 PM Tuesday, May 05, 2009

Page 1 of 53

IR1
Int. Instr II:
INPUT FIELDS / ROUTING
IR_CASEOK

Field1:
Cheshire Name:

( IRQ1010 )

TEMP

Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNo

FieldSize:
Min Value:
Max Value:
Mask:

1
No
No

Route
IR3 - RRECHELP ( IRQ1040 )

Number Label
1 Yes
2

English text: YES
No

BOX IR2 - (IRQ1020 )

English text: NO

BACKGROUND VARIABLE ASSIGNMENTS
If IR1 - IR_CASEOK = 1/Yes, create a current round IRQS record where IRQS.IRQSRND =
current round and IRQS.IRQSRESP = 01.
IRQS Key = IRQS.IRQSBASE + IRQS.IRQSRND + IRQS.IRQSRESP.
See instructions below.
IRQSRND

IRQS.IRQSRND = current round.

IRQSRESP

IRQS.IRQSRESP = 01.

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
4

Respondent

On MRES where MRES.MRESRND = current round:
A Proxy interview (respondent is a proxy) =
MRES.SPPROXY=2/Proxy.
MRES.RROSTNUM=ROST.ROSTNUM of respondent.

4:38:46 PM Tuesday, May 05, 2009

Page 2 of 53

IR1
An SP interview (respondent is the SP) =
MRES.SPPROXY=1/SP.
MRES.RROSTNUM='01'.
15

ProxyName

Proxy's name and relationship =
Stored on ROST where
ROST.ROSTNUM=MRES.RROSTNUM.
First Name: ROST.ROSTFNAM
Last Name: ROST.ROSTLNAM
Relationship: ROST.ROSTREL.
If ROST.ROSTREL=91/OtherRelative or 92/OtherNonRelative, Relationship=ROST.ROSTREOS.

DESIGN NOTES

4:38:46 PM Tuesday, May 05, 2009

Page 3 of 53

BOX IR2

BOX IR2

Page Order # :

20

BOX INSTRUCTIONS
( IRQ1020 )

RETURN TO IMS .

ASSIGNMENTS

TECHNICAL NOTES

DESIGN NOTES

4:38:46 PM Tuesday, May 05, 2009

Page 4 of 53

IR3

IR3

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

RRECHELP

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

40

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:
Question display:

If Proxy was respondent, display "(PROXY NAME)".
Else display "(SP)".

Multi Field display:

Roster/Grid Instructions:
Roster/Grid display:
Report display:

TEXT:
Context Header:
Int. Instr I:

DID [(SP)/(PROXY NAME)] RECEIVE ANY HELP IN ANSWERING
THE QUESTIONS?

Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING

4:38:47 PM Tuesday, May 05, 2009

Page 5 of 53

IR3
( IRQ1040 )

RRECHELP

Field1:
Cheshire Name:

IRQS.RRECHELP

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNo

FieldSize:
Min Value:
Max Value:
Mask:

1
No
No

Number Label
1 Yes
2

Route
IR4 - PERSON_HELPER ( IRQ1050 )

English text: YES
No

IR5 - RINFOSAT ( IRQ1060 )

English text: NO

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
4

Respondent

On MRES where MRES.MRESRND = current round:
A Proxy interview (respondent is a proxy) =
MRES.SPPROXY=2/Proxy.
MRES.RROSTNUM=ROST.ROSTNUM of respondent.
An SP interview (respondent is the SP) =
MRES.SPPROXY=1/SP.
MRES.RROSTNUM='01'.

4:38:49 PM Tuesday, May 05, 2009

Page 6 of 53

IR3
15

ProxyName

Proxy's name and relationship =
Stored on ROST where
ROST.ROSTNUM=MRES.RROSTNUM.
First Name: ROST.ROSTFNAM
Last Name: ROST.ROSTLNAM
Relationship: ROST.ROSTREL.
If ROST.ROSTREL=91/OtherRelative or 92/OtherNonRelative, Relationship=ROST.ROSTREOS.

DESIGN NOTES

4:38:49 PM Tuesday, May 05, 2009

Page 7 of 53

IR4

IR4

Page Order # :

Design Screen Type:

Roster

Fields:

Field 1:

PERSON_HELPER

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Name:

Person Roster

Roster Type:

Single Item Select

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

Yes
Yes
No
Yes

Grid Functions:

Add Line
Delete Line

No
No

50

Display as ' Add a Person '
Display as ' Edit a Person '

DISPLAY INSTRUCTIONS:
Context header display:
Question display:

If Proxy was respondent, display "(PROXY NAME)".
Else display "(SP)".

Multi Field display:

Roster/Grid Instructions:

Display all persons from Person Roster.
Display SP on first line, where ROST.ROSTNUM=01.

If Proxy interview, display Proxy on second line, where

ROST.ROSTNUM=MRES.RROSTNUM.

Display remaining persons in the order that they were entered in

Person Roster.

Display the following persons as protected rows:

1) The SP, if SP interview or SP deceased.

2) The Proxy, if Proxy interview.

3) All persons who are deceased. These are persons who at some

point lived in the Household but were later reported deceased.

Roster/Grid display:

4:38:49 PM Tuesday, May 05, 2009

COL #

HEADER

INSTRUCTIONS

1

First Name

Display ROST.ROSTFNAM

2

Last Name

Display ROST.ROSTLNAM

Page 8 of 53

IR4
3

Relationship to SP

Display relationship:
If ROST.ROSTREL=91/OtherRelative or
92/OtherNon-Relative, display
ROST.ROSTREOS.
Else display ROST.ROSTREL
relationship.

Report display:

TEXT:
Context Header:
WHO HELPED [(SP)/(PROXY NAME)] ANSWER THE QUESTIONS?

Int. Instr I:
Question Text:

SELECT OR ADD ONLY ONE PERSON.

Int. Instr II:
INPUT FIELDS / ROUTING

Field1:
Cheshire Name:

PERSON_HELPER

( IRQ1050 )

TEMP

Item Text display:
Item Text:

TEMP

Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

String
TRostPick8
1

No
No

Number Label
1 [Continuous answer.]

FieldSize:
Min Value:

Max Value:

Mask:

8

Route
IR5 - RINFOSAT ( IRQ1060 )

BACKGROUND VARIABLE ASSIGNMENTS
If Person added, see PERSON ROSTER POP-UP specifications for pop-up window
programming instructions.
Variables populated in Person Roster:
ROST.ROSTNUM Person's unique #
ROST.ROSTRNDC Round # ROST created
ROST.ROSTFNAM First Name
ROST.ROSTLNAM Last Name
ROST.ROSTREL
Relationship to SP
ROST.ROSTREOS Relationship to SP, Other Specify.
4:38:50 PM Tuesday, May 05, 2009

Page 9 of 53

IR4
Set reason why person added to Person Roster. See instructions below.
Person select at Person Roster is the helper. Store the respondent number on
IRQS.RHELPNUM. See intructions below.
RHELPNUM

IRQS.RHELPNUM=ROST.ROSTNUM of person
selected as helper at IR4.

ROSTREAS

If person added to person roster, set
ROST.ROSTREAS = 10/AssistantToRespondent.

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
4

Respondent

On MRES where MRES.MRESRND = current round:
A Proxy interview (respondent is a proxy) =
MRES.SPPROXY=2/Proxy.
MRES.RROSTNUM=ROST.ROSTNUM of respondent.
An SP interview (respondent is the SP) =
MRES.SPPROXY=1/SP.
MRES.RROSTNUM='01'.

15

ProxyName

Proxy's name and relationship =
Stored on ROST where
ROST.ROSTNUM=MRES.RROSTNUM.
First Name: ROST.ROSTFNAM
Last Name: ROST.ROSTLNAM
Relationship: ROST.ROSTREL.
If ROST.ROSTREL=91/OtherRelative or 92/OtherNonRelative, Relationship=ROST.ROSTREOS.

59

SPStatus

SP is Alive and not institutionalized =
MRES.SPALIVE=1/Alive or empty
SP is Alive =

MRES.SPALIVE=1/Alive, 2/AliveAndInstitute, or EMPTY

SP is Institutionalized =

MRES.SPALIVE=2/AliveAndInstitute

SP is Deceased =

MRES.SPALIVE=3/Deceased.

352

PersonIsDeceased

Persons identified as being deceased =
There is a ROST & ENUM where
(ENUM.ENUMROST=ROST.ROSTNUM &
ENUM.ENUMRND=any round & ENUM.NOTHHRSN =
1/Deceased).

DESIGN NOTES

4:38:50 PM Tuesday, May 05, 2009

Page 10 of 53

IR5

IR5

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

RINFOSAT

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
No
No

60

Roster Name:
Roster Type:
Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

DISPLAY INSTRUCTIONS:
Context header display:
Question display:

If Proxy was respondent, display "(PROXY NAME)".
Else display "(SP)".

Multi Field display:

Roster/Grid Instructions:
Roster/Grid display:
Report display:

TEXT:
Context Header:
Int. Instr I:

DO YOU FEEL THAT THE INFORMATION PROVIDED BY
[(SP)/(PROXY NAME)] WAS SATISFACTORY?

Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING

4:38:51 PM Tuesday, May 05, 2009

Page 11 of 53

IR5
( IRQ1060 )

RINFOSAT

Field1:
Cheshire Name:

IRQS.RINFOSAT

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNo

FieldSize:
Min Value:
Max Value:
Mask:

1
No
No

Number Label
1 Yes
2

Route
BOX IR3 - (IRQ1100 )

English text: YES
No

IR5OV - RINFOVB ( IRQ1070 )

English text: NO

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
4

Respondent

On MRES where MRES.MRESRND = current round:
A Proxy interview (respondent is a proxy) =
MRES.SPPROXY=2/Proxy.
MRES.RROSTNUM=ROST.ROSTNUM of respondent.
An SP interview (respondent is the SP) =
MRES.SPPROXY=1/SP.
MRES.RROSTNUM='01'.

4:38:53 PM Tuesday, May 05, 2009

Page 12 of 53

IR5
15

ProxyName

Proxy's name and relationship =
Stored on ROST where
ROST.ROSTNUM=MRES.RROSTNUM.
First Name: ROST.ROSTFNAM
Last Name: ROST.ROSTLNAM
Relationship: ROST.ROSTREL.
If ROST.ROSTREL=91/OtherRelative or 92/OtherNonRelative, Relationship=ROST.ROSTREOS.

DESIGN NOTES

4:38:53 PM Tuesday, May 05, 2009

Page 13 of 53

IR5OV

IR5OV

Page Order # :

Design Screen Type:

Verbatim Text

Fields:

Field 1:

RINFOVB

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

70

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Multi Field display:

Roster/Grid Instructions:

Roster/Grid display:

Report display:

TEXT:

Context Header:
Int. Instr I:

RECORD THE REASONS WHY YOU THINK THAT THE
INFORMATION PROVIDED WAS UNSATISFACTORY.

Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING

4:38:53 PM Tuesday, May 05, 2009

Page 14 of 53

IR5OV

Field1:
Cheshire Name:

RINFOVB

( IRQ1070 )

NONE
REPLACES CHESHIRE VARIABLES:
IRQS.RINFOVB1
IRQS.RINFOVB2
IRQS.RINFOVB3

Item Text display:
Item Text:
Label:

Label Position:

Field Type:

Type Name:

Answers Allowed:

Drop Down List:

Lookup File:

Lookup File Name:

Open
TOpen135
1
No
No

Number Label
1 [Continuous answer.]

FieldSize:
Min Value:
Max Value:
Mask:

135

Route
BOX IR3 - (IRQ1100 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

4:38:54 PM Tuesday, May 05, 2009

Page 15 of 53

BOX IR3

BOX IR3

Page Order # :

80

BOX INSTRUCTIONS
( IRQ1100 )

IF (SP IS IN THE SUPPLEMENTAL SAMPLE) OR (SP'S PREVIOUS ROUND
INTERVIEW WAS IN A FACILITY), GO TO IR5B - USEBATRY ( IRQ1170 ).
ELSE GO TO IR5A - REFERCAL ( IRQ1110 ).

ASSIGNMENTS

TECHNICAL NOTES
9

SuppORD

SP is in the Supplemental Sample =
MRES.INTTYPE=3/NewFromSupplement on MRES
where MRES.MRESRND = current round.

11

FacInterview

Previous round was a facility interview =
(MRES.INTTYPE=2/NewFromFacility or
MRES.INTTYPE=5/LastRndFacSum or
MRES.INTTYPE=6/LastRndFacBase) on MRES where
MRES.MRESRND = current round.

DESIGN NOTES

4:38:54 PM Tuesday, May 05, 2009

Page 16 of 53

IR5A

IR5A

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

REFERCAL

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

90

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Multi Field display:

Roster/Grid Instructions:

Roster/Grid display:

Report display:

TEXT:

Context Header:
Int. Instr I:

DURING THE INTERVIEW, DID THE RESPONDENT REFER TO
ENTRIES MADE BY THE RESPONDENT OR THE SP IN THE
CALENDAR PROVIDED BY MCBS?

Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING

4:38:55 PM Tuesday, May 05, 2009

Page 17 of 53

IR5A
REFERCAL

Field1:
Cheshire Name:

( IRQ1110 )

IRQS.REFERCAL

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNo
1
No
No

Number Label
1 Yes
2

English text: YES
No

FieldSize:
Min Value:
Max Value:
Mask:

Route
IR5B - USEBATRY ( IRQ1170 )
IR5AA - REFSPCAL ( IRQ1120 )

English text: NO

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

4:38:56 PM Tuesday, May 05, 2009

Page 18 of 53

IR5AA

IR5AA

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

REFSPCAL

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

100

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Display the word "NOT" in bold.

Multi Field display:

Roster/Grid Instructions:

Roster/Grid display:

Report display:

TEXT:

Context Header:
Int. Instr I:

DURING THE INTERVIEW, DID THE RESPONDENT REFER TO
ENTRIES THE RESPONDENT OR SP HAD MADE IN ANY
CALENDAR THAT WAS NOT PROVIDED BY MCBS?

Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING

4:38:57 PM Tuesday, May 05, 2009

Page 19 of 53

IR5AA
REFSPCAL

Field1:
Cheshire Name:

( IRQ1120 )

IRQS.REFSPCAL

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNo
1
No
No

Number Label
1 Yes
2

English text: YES
No

FieldSize:
Min Value:
Max Value:
Mask:

Route
IR5B - USEBATRY ( IRQ1170 )
IR5B - USEBATRY ( IRQ1170 )

English text: NO

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

4:38:59 PM Tuesday, May 05, 2009

Page 20 of 53

IR5B

IR5B

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

USEBATRY

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

140

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Multi Field display:

Roster/Grid Instructions:

Roster/Grid display:

Report display:

TEXT:

Context Header:
Int. Instr I:

DID YOU USE BATTERY POWER TO CONDUCT THIS
INTERVIEW?

Question Text:
Int. Instr II:

INCLUDE ANY PORTION OF A “RESTART” INTERVIEW.

INPUT FIELDS / ROUTING

4:39:00 PM Tuesday, May 05, 2009

Page 21 of 53

IR5B
USEBATRY

Field1:
Cheshire Name:

( IRQ1170 )

IRQS.USEBATRY

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNo
1
No
No

Number Label
1 Yes
2

English text: YES
No

FieldSize:
Min Value:
Max Value:
Mask:

Route
IR5C - INTVTIME ( IRQ1180 )
IR5C - INTVTIME ( IRQ1180 )

English text: NO

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

4:39:01 PM Tuesday, May 05, 2009

Page 22 of 53

IR5C

IR5C

Page Order # :

Design Screen Type:

Code 1

Fields:

Field 1:

INTVTIME

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

150

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Multi Field display:

Roster/Grid Instructions:

Roster/Grid display:

Report display:

TEXT:

Context Header:
Int. Instr I:

HOW LONG WAS THIS INTERVIEW?

Question Text:
Int. Instr II:

INCLUDE ALL THE TIME YOU SPENT IN THE RESPONDENT’S
HOME.

INPUT FIELDS / ROUTING

4:39:03 PM Tuesday, May 05, 2009

Page 23 of 53

IR5C
INTVTIME

Field1:
Cheshire Name:

( IRQ1180 )

IRQS.INTVTIME

Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TIntvtime
1
No
No

Number Label
1 LessThan1Hour

FieldSize:
Min Value:
Max Value:
Mask:

Route
IR6 - ANYFIX ( IRQ1240 )

2

English text: LESS THAN 1 HOUR
From1To2Hours

IR6 - ANYFIX ( IRQ1240 )

3

English text: FROM 1-2 HOURS
From2To4Hours

IR5D - LT_REASON ( IRQ1190 )

4

English text: FROM 2-4 HOURS
MoreThan4Hours

IR5D - LT_REASON ( IRQ1190 )

English text: MORE THAN 4 HOURS

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

4:39:05 PM Tuesday, May 05, 2009

Page 24 of 53

IR5D

IR5D

Page Order # :

Design Screen Type:

Code All

Fields:

Field 1:

LT_REASON

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

160

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Multi Field display:

Roster/Grid Instructions:

Roster/Grid display:

Report display:

TEXT:

Context Header:
Int. Instr I:

WHY DO YOU THINK THIS INTERVIEW TOOK AS LONG AS IT
DID?

Question Text:
Int. Instr II:

CHECK ALL THAT APPLY.

INPUT FIELDS / ROUTING

4:39:07 PM Tuesday, May 05, 2009

Page 25 of 53

IR5D
LT_REASON

Field1:
Cheshire Name:

( IRQ1190 )

NONE
REPLACES THE FOLLOWING CHESHIRE VARIABLES:
1=IRQS.LT_UTILZ

2=IRQS.LT_STMTS

3=IRQS.LT_CNFUS

4=IRQS.LT_INTER

5=IRQS.LT_ALWAY

91=IRQS.LT_OTHER

Item Text display:

If (SP is in the Supplemental Sample) or (this is the SP's
exit interview), do not display response options
1/HeavyUtilization, 2/ManyStatements, or
5/AlwaysTakesThisLong.

Item Text:
Label:

Label Position:

Field Type:

Type Name:

Answers Allowed:

Drop Down List:

Lookup File:

Lookup File Name:

Enumerated
TLT_Reason
6
No
No

Number Label
1 HeavyUtilization

FieldSize:
Min Value:
Max Value:
Mask:

Route
IR6 - ANYFIX ( IRQ1240 )

2

English text: HEAVY UTILIZATION
ManyStatements

IR6 - ANYFIX ( IRQ1240 )

3

English text: MANY STATEMENTS
RWasConfused

IR6 - ANYFIX ( IRQ1240 )

4

English text: R WAS CONFUSED/RAMBLING
ManyInterruptions
IR6 - ANYFIX ( IRQ1240 )

5

English text: MANY INTERRUPTIONS
AlwaysTakesThisLong

IR6 - ANYFIX ( IRQ1240 )

English text: ALWAYS TAKES THIS LONG
Other

IR5I - LT_OTHERWHY ( IRQ1195 )

91

English text: OTHER

BACKGROUND VARIABLE ASSIGNMENTS
4:39:11 PM Tuesday, May 05, 2009

Page 26 of 53

IR5D

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
9

SuppORD

SP is in the Supplemental Sample =
MRES.INTTYPE=3/NewFromSupplement on MRES
where MRES.MRESRND = current round.

16

ExitSample

SP is in the Exit Sample =
(MRES.INTTYPE = 8/ExitInterviewHadPrev or
9/ExitInterviewSkipPrev) on MRES where
MRES.MRESRND = current round.

DESIGN NOTES

4:39:11 PM Tuesday, May 05, 2009

Page 27 of 53

IR5I

IR5I

Page Order # :

Design Screen Type:

No Entry

Fields:

Field 1:

LT_OTHERWHY

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

170

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Multi Field display:

Roster/Grid Instructions:

Roster/Grid display:

Report display:

TEXT:

Context Header:
Int. Instr I:

PLEASE ENTER A COMMENT TO PROVIDE MORE
INFORMATION ABOUT THE LENGTH OF THE INTERVIEW.

Question Text:
Int. Instr II:

USE THE COMMET " LINK" AT THE TOP OF THE SCREEN TO
ACTIVATE THE COMMENT BOX.

INPUT FIELDS / ROUTING

4:39:12 PM Tuesday, May 05, 2009

Page 28 of 53

IR5I
LT_OTHERWHY

Field1:
Cheshire Name:

( IRQ1195 )

TEMP

Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TContinueEMPTY
1
No
No

Number Label
1 Continue

FieldSize:
Min Value:
Max Value:
Mask:

Route
IR6 - ANYFIX ( IRQ1240 )

English text: CONTINUE
Attribute
Empty

Route
IR6 - ANYFIX ( IRQ1240 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

4:39:14 PM Tuesday, May 05, 2009

Page 29 of 53

IR6

IR6

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

ANYFIX

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

190

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Always display "[THIS INCLUDES….]" in brackets.

Multi Field display:

Roster/Grid Instructions:

Roster/Grid display:

Report display:

TEXT:

Context Header:
Int. Instr I:

IS THERE ANYTHING YOU HAVE RECORDED IN THE CAPI
PROGRAM THAT YOU WOULD LIKE HOME OFFICE STAFF TO
FIX?

Question Text:
Int. Instr II:

[THIS INCLUDES DATA ITEMS THAT YOU WOULD LIKE THE
DATA EDITING STAFF TO FIX.]

INPUT FIELDS / ROUTING

4:39:15 PM Tuesday, May 05, 2009

Page 30 of 53

IR6
ANYFIX

Field1:
Cheshire Name:

( IRQ1240 )

IRQS.ANYFIX

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNo
1
No
No

Number Label
1 Yes
2

English text: YES
No

FieldSize:
Min Value:
Max Value:
Mask:

Route
IR6A - ANYFIXWHAT ( IRQ1250 )
BOX IR3B - (IRQ1260 )

English text: NO

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

4:39:16 PM Tuesday, May 05, 2009

Page 31 of 53

IR6A

IR6A

Page Order # :

Design Screen Type:

No Entry

Fields:

Field 1:

ANYFIXWHAT

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

200

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Multi Field display:

Roster/Grid Instructions:

Roster/Grid display:

Report display:

TEXT:

Context Header:
Int. Instr I:

PLEASE ENTER A COMMENT TO DESCRIBE IN AS MUCH

DETAIL AS POSSIBLE WHAT YOU WOULD LIKE TO HAVE FIXED.

Question Text:
Int. Instr II:

USE THE COMMENT "LINK" AT THE TOP OF THE SCREEN TO

ACTIVATE THE COMMENT BOX.

INPUT FIELDS / ROUTING

4:39:17 PM Tuesday, May 05, 2009

Page 32 of 53

IR6A
ANYFIXWHAT

Field1:
Cheshire Name:

( IRQ1250 )

TEMP

Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TContinueEMPTY
1
No
No

Number Label
1 Continue

FieldSize:
Min Value:
Max Value:
Mask:

Route
BOX IR3B - (IRQ1260 )

English text: CONTINUE
Attribute
Empty

Route
BOX IR3B - (IRQ1260 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

4:39:19 PM Tuesday, May 05, 2009

Page 33 of 53

BOX IR3B

BOX IR3B

4:39:19 PM Tuesday, May 05, 2009

Page Order # :

210

Page 34 of 53

BOX IR3B
BOX INSTRUCTIONS
( IRQ1260 )

IF SP IS DECEASED, GO TO IR8 - MORTRAIN ( IRQ1370 ).
ELSE IF SP IS IN THE EXIT SAMPLE, GO TO IR7 - INTCOMM ( IRQ1270 ).
ELSE IF (SP IS IN THE SUPPLEMENTAL SAMPLE) OR (SP'S PREVIOUS
ROUND INTERVIEW WAS IN A FACILITY) OR (DRIVING DIRECTIONS
WERE NOT REPORTED IN THE PREVIOUS ROUND), GO TO IR6B ­
IRDRIVE ( IRQ1265 ).
ELSE GO TO IR6C - IRDRIVEVB ( IRQ1269 ).

ASSIGNMENTS
If SP is not in the supplemental sample and SP's previous round interview was not in a
facility and driving directions were reported in the previous round, we will copy the previous
round driving directions to the current round IRQS record and allow the interviewer to
update the directions at IR6C. See detailed instructions below.
IRDRIVEVB

If (SP is not in the Supplemental Sample) and (SP's
previous round interview was not in a facility) and
(previous round IRQS.IRDRIVEVB ^= EMPTY), copy
previous round IRQS.IRDRIVEVB to the current
round IRQS.IRDRIVEVB.

TECHNICAL NOTES
59

SPStatus

SP is Alive and not institutionalized =
MRES.SPALIVE=1/Alive or empty
SP is Alive =
MRES.SPALIVE=1/Alive, 2/AliveAndInstitute, or EMPTY
SP is Institutionalized =
MRES.SPALIVE=2/AliveAndInstitute
SP is Deceased =
MRES.SPALIVE=3/Deceased.

16

ExitSample

SP is in the Exit Sample =
(MRES.INTTYPE = 8/ExitInterviewHadPrev or
9/ExitInterviewSkipPrev) on MRES where
MRES.MRESRND = current round.

9

SuppORD

SP is in the Supplemental Sample =
MRES.INTTYPE=3/NewFromSupplement on MRES
where MRES.MRESRND = current round.

11

FacInterview

Previous round was a facility interview =
(MRES.INTTYPE=2/NewFromFacility or
MRES.INTTYPE=5/LastRndFacSum or
MRES.INTTYPE=6/LastRndFacBase) on MRES where
MRES.MRESRND = current round.

353

PrevDrivingDirections

Driving directions reported in the previous round =
IRQS.IRDRIVEVB ^= empty on IRQS where
IRQS.IRQSRND = previous round.
IRQS.IRDRIVEVB is stored in multiple VB fields in
Cheshire, IRQS.IRDRIVE1 through IRQS.IRDRIVE9.

DESIGN NOTES
4:39:19 PM Tuesday, May 05, 2009

Page 35 of 53

BOX IR3B

4:39:19 PM Tuesday, May 05, 2009

Page 36 of 53

IR6B

IR6B

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

IRDRIVE

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

213

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Multi Field display:

Roster/Grid Instructions:

Roster/Grid display:

Report display:

TEXT:

Context Header:
Int. Instr I:

ARE THERE DRIVING DIRECTIONS YOU CAN ENTER FOR THE
NEXT INTERVIEW?

Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING

4:39:20 PM Tuesday, May 05, 2009

Page 37 of 53

IR6B
IRDRIVE

Field1:
Cheshire Name:

( IRQ1265 )

IRQS.IRDRIVE

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNo
1
No
No

Number Label
1 Yes
2

English text: YES
No

FieldSize:
Min Value:
Max Value:
Mask:

Route
IR6C - IRDRIVEVB ( IRQ1269 )
IR7 - INTCOMM ( IRQ1270 )

English text: NO

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

4:39:22 PM Tuesday, May 05, 2009

Page 38 of 53

IR6C

IR6C

Page Order # :

Design Screen Type:

Verbatim Text

Fields:

Field 0:

IRDRIVEVB

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

217

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:
Question display:

If coming from IR6B, IR6B - IRDRIVE = 1/Yes, display "ENTER".
Else display "REVIEW".
If not coming from IR6B, IR6B - IRDRIVE = empty, display
"DISPLAYED", and "UPDATE OR REVISE AS NECESSARY.".
Else do not display.

Multi Field display:

Roster/Grid Instructions:
Roster/Grid display:
Report display:

TEXT:
Context Header:
Int. Instr I:

(ENTER/REVIEW) THE DRIVING DIRECTIONS FOR THE NEXT
INTERVIEW (DISPLAYED) IN THE TEXT BOX BELOW. (UPDATE
OR REVISE AS NECESSARY.)

Question Text:
Int. Instr II:

4:39:22 PM Tuesday, May 05, 2009

Page 39 of 53

IR6C
INPUT FIELDS / ROUTING

Field0:
Cheshire Name:

IRDRIVEVB

( IRQ1269 )

NONE
REPLACES CHESHIRE VARIABLES:

IRQS.IRDRIVE1

IRQS.IRDRIVE2

IRQS.IRDRIVE3

IRQS.IRDRIVE4

IRQS.IRDRIVE5

IRQS.IRDRIVE6

IRQS.IRDRIVE7

IRQS.IRDRIVE8

IRQS.IRDRIVE9

Item Text display:
Item Text:

If IRQS.IRDRIVEVB ^= EMPTY, display driving directions at

IR6C and allow text to be edited.

Otherwise, collect driving directions.

Label:

Label Position:

Field Type:

Type Name:

Answers Allowed:

Drop Down List:

Lookup File:

Lookup File Name:

Open

TOpen315
1
No
No

Number Label
1 [Continuous answer.]

FieldSize:
Min Value:
Max Value:
Mask:

315

Route
IR7 - INTCOMM ( IRQ1270 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

4:39:23 PM Tuesday, May 05, 2009

Page 40 of 53

IR7

IR7

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

INTCOMM

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

220

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:
Question display:

Always display "(OTHER)" in parenthesis.
If SP is not in the Exit Sample, display "THAT COULD HELP THE
NEXT INTERVIEWER COMPLETE THIS CASE".
Else do not display.

Multi Field display:

Roster/Grid Instructions:
Roster/Grid display:
Report display:

TEXT:
Context Header:
Int. Instr I:

ARE THERE ANY (OTHER) COMMENTS YOU WOULD LIKE TO
MAKE ABOUT THE RESPONDENT OR INTERVIEWING
SITUATION (THAT COULD HELP THE NEXT INTERVIEWER
COMPLETE THIS CASE)?

Question Text:
Int. Instr II:

4:39:24 PM Tuesday, May 05, 2009

Page 41 of 53

IR7
INPUT FIELDS / ROUTING
( IRQ1270 )

INTCOMM

Field1:
Cheshire Name:

IRQS.INTCOMM

Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNo

FieldSize:
Min Value:
Max Value:
Mask:

1
No
No

Route
IR7OV - INTCVB ( IRQ1280 )

Number Label
1 Yes
2

English text: YES
No
English text: NO

IR7A - OUTSTATE ( IRQ1360 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
16

ExitSample

SP is in the Exit Sample =
(MRES.INTTYPE = 8/ExitInterviewHadPrev or
9/ExitInterviewSkipPrev) on MRES where
MRES.MRESRND = current round.

DESIGN NOTES

4:39:25 PM Tuesday, May 05, 2009

Page 42 of 53

IR7OV

IR7OV

Page Order # :

Design Screen Type:

Verbatim Text

Fields:

Field 1:

INTCVB

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

230

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Multi Field display:

Roster/Grid Instructions:

Roster/Grid display:

Report display:

TEXT:

Context Header:
Int. Instr I:

ENTER THE COMMENTS YOU WOULD LIKE TO MAKE ABOUT
THE RESPONDENT OR INTERVIEWING SITUATION. DO NOT
INCLUDE COMMENTS HERE THAT YOU WANT THE DATA
EDITING STAFF TO FIX.

Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING

4:39:26 PM Tuesday, May 05, 2009

Page 43 of 53

IR7OV

Field1:
Cheshire Name:

INTCVB

( IRQ1280 )

NONE
REPLACES CHESHIRE VARIABLES:

IRQS.INTCVB1

IRQS.INTCVB2

IRQS.INTCVB3

IRQS.INTCVB4

IRQS.INTCVB5

IRQS.INTCVB6

Item Text display:
Item Text:
Label:

Label Position:

Field Type:

Type Name:

Answers Allowed:

Drop Down List:

Lookup File:

Lookup File Name:

Open
TOpen270
1
No
No

Number Label
1 [Continuous answer.]

FieldSize:
Min Value:
Max Value:
Mask:

270

Route
IR7A - OUTSTATE ( IRQ1360 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

4:39:26 PM Tuesday, May 05, 2009

Page 44 of 53

IR7A

IR7A

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

OUTSTATE

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

240

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Always dispay "[THAT IS, THE SP….]" in brackets.

Multi Field display:

Roster/Grid Instructions:

Roster/Grid display:

Report display:

TEXT:

Context Header:
Int. Instr I:

IS THIS A “SNOWBIRD” CASE?

Question Text:
Int. Instr II:

[THAT IS, THE SP HAS A PLACE WHERE HE/SHE SPENDS
MORE THAN ONE MONTH AWAY FROM HIS/HER PRIMARY
HOME].

INPUT FIELDS / ROUTING

4:39:28 PM Tuesday, May 05, 2009

Page 45 of 53

IR7A
OUTSTATE

Field1:
Cheshire Name:

( IRQ1360 )

IRQS.OUTSTATE

Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNoDKRF
1
No
No

Number Label
1 Yes
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
IR8 - MORTRAIN ( IRQ1370 )

English text: YES
No

IR8 - MORTRAIN ( IRQ1370 )

English text: NO
Attribute
Don't know

Route
IR8 - MORTRAIN ( IRQ1370 )

Refusal

IR8 - MORTRAIN ( IRQ1370 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

4:39:30 PM Tuesday, May 05, 2009

Page 46 of 53

IR8

IR8

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

MORTRAIN

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

250

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Multi Field display:

Roster/Grid Instructions:

Roster/Grid display:

Report display:

TEXT:

Context Header:
Int. Instr I:

ARE THERE ANY PROBLEMS YOU ENCOUNTERED ON WHICH
YOU WOULD LIKE MORE TRAINING?

Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING

4:39:31 PM Tuesday, May 05, 2009

Page 47 of 53

IR8
MORTRAIN

Field1:
Cheshire Name:

( IRQ1370 )

IRQS.MORTRAIN

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNo
1
No
No

Number Label
1 Yes
2

English text: YES
No

FieldSize:
Min Value:
Max Value:
Mask:

Route
IR8A - MORTRAINWHAT ( IRQ1395 )
IR10 - SAVEIRQ ( IRQ1400 )

English text: NO

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

4:39:32 PM Tuesday, May 05, 2009

Page 48 of 53

IR8A

IR8A

Page Order # :

Design Screen Type:

No Entry

Fields:

Field 1:

MORTRAINWHAT

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

255

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Multi Field display:

Roster/Grid Instructions:

Roster/Grid display:

Report display:

TEXT:

Context Header:
Int. Instr I:

PLEASE ENTER A COMMENT TO PROVIDE MORE
INFORMATION ABOUT THE PROBLEMS YOU ENCOUNTERED
AND THE ADDITIONAL TRAINING YOU WOULD LIKE.

Question Text:
Int. Instr II:

USE THE COMMENT " LINK" AT THE TOP OF THE SCREEN TO
ACTIVATE THE COMMENT BOX.

INPUT FIELDS / ROUTING

4:39:33 PM Tuesday, May 05, 2009

Page 49 of 53

IR8A
MORTRAINWHAT

Field1:
Cheshire Name:

( IRQ1395 )

TEMP

Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TContinueEMPTY
1
No
No

Number Label
1 Continue

FieldSize:
Min Value:
Max Value:
Mask:

Route
IR10 - SAVEIRQ ( IRQ1400 )

English text: CONTINUE
Attribute
Empty

Route
IR10 - SAVEIRQ ( IRQ1400 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

4:39:35 PM Tuesday, May 05, 2009

Page 50 of 53

IR10

IR10

Page Order # :

Design Screen Type:

No Entry

Fields:

Field 1:

SAVEIRQ

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

260

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Multi Field display:

Roster/Grid Instructions:

Roster/Grid display:

Report display:

TEXT:

Context Header:

Int. Instr I:

IRQ SESSION IS COMPLETE.

Question Text:

Int. Instr II:

INPUT FIELDS / ROUTING

4:39:36 PM Tuesday, May 05, 2009

Page 51 of 53

IR10
SAVEIRQ

Field1:
Cheshire Name:

( IRQ1400 )

TEMP

Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TContinueEMPTY
1
No
No

Number Label
1 Continue

FieldSize:
Min Value:
Max Value:
Mask:

Route
BOX IREND - (IRQ1405 )

English text: CONTINUE
Attribute
Empty

Route
BOX IREND - (IRQ1405 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

4:39:38 PM Tuesday, May 05, 2009

Page 52 of 53

BOX IREND

BOX IREND

Page Order # :

265

BOX INSTRUCTIONS
( IRQ1405 )

RETURN TO IMS .

ASSIGNMENTS

TECHNICAL NOTES

DESIGN NOTES

4:39:38 PM Tuesday, May 05, 2009

Page 53 of 53