Canadian Survey on Disability - 2022
For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.
Table of Contents
- ENTRY (ENT)
- SEX AND GENDER (GDR)
- DISABILITY SCREENING QUESTIONS (DSQ)
- EPISODIC DISABILITIES (EPD)
- MAIN CONDITION (MC)
- ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH)
- ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - VISION (AADV)
- ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM)
- ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - LEARNING AND DEVELOPMENTAL (AADL)
- ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA)
- MEDICATION USE (MED)
- CANNABIS USE (CAN)
- HELP RECEIVED (HRE)
- HEALTH CARE THERAPIES AND SERVICES (HTS)
- EDUCATION (EDU)
- EDUCATIONAL EXPERIENCES (EEX)
- EDUCATIONAL BACKGROUND (EDB)
- LABOUR MARKET ACTIVITIES MINIMAL (LMAM)
- LABOUR FORCE STATUS (LMA2)
- CLASS OF WORKER (LMA3)
- SELF-EMPLOYED (SEMP)
- JOB TENURE (JT)
- INDUSTRY (LMA4)
- OCCUPATION (LMA5)
- WORKPLACE (WKPL)
- USUAL HOURS OF WORK (LMA6)
- PART-TIME EMPLOYMENT (PT)
- PERMANENT WORK (PW)
- PERIODS OF UNEMPLOYMENT (POU)
- EMPLOYMENT DETAILS (EDE)
- LOOKING FOR WORK (LW)
- PAST JOB ATTACHMENT (PJA)
- CLASSIFICATION OF RETIREMENT (RETC)
- RETIREMENT DETAILS (RDE)
- UNEMPLOYED DETAILS (UDE)
- NOT IN THE LABOUR FORCE DETAILS (NDE)
- LABOUR MARKET ATTACHMENT (LA)
- PERIODS OF EMPLOYMENT (POE)
- WORKPLACE TRAINING (WTR)
- EMPLOYMENT MODIFICATIONS (EMO)
- LABOUR FORCE DISCRIMINATION (LFD)
- VETERANS (VAC)
- INTERNET USE (IU)
- ACCESSIBILITY BARRIERS (BAR)
- GENERAL HEALTH (GH)
- HOUSEBOUND (HB)
- SOCIAL ISOLATION (SI)
- SOURCES OF INCOME (SNC)
- FOOD SECURITY (FS)
- HOMELESSNESS (HOM)
- COVID-19 (COV)
- SEXUAL ORIENTATION (SOR)
- SELF-IDENTIFICATION (DIS)
- FUTURE SURVEYS (SUR)
ENTRY (ENT)
ENTRY (ENT) - Question identifier:ENT_R05
Person selected for this survey
[First Name] [Last Name]
ENTRY (ENT) - Question identifier:ENT_Q05
Please select one of the following:
- 1: I am completing this survey on behalf of [First Name] [Last Name]
- 2: I am [First Name] [Last Name] and completing this survey for myself
ENTRY (ENT) - Question identifier:ENT_Q10
Why are you completing this survey on behalf of [First Name] [Last Name]?
- 01: The person is unable to participate for health reasons
- 02: The person is absent or unavailable
- 03: The person does not speak either English or French
- 04: I am a parent or guardian responding on behalf of a child
- 05: The person is deceased
- 06: The person moved to an institution (e.g., hospital, health care facility, etc.)
- 07: The person no longer lives in Canada
- 08: Other reason Specify the reason you are completing the survey on behalf of [First Name] [Last Name]:
ENTRY (ENT) - Question identifier:ENT_R15
Please review the [information about [First Name] [Last Name]/following information]. If incorrect (including spelling), please select the item and enter the correct information.
ENTRY (ENT) - Question identifier:ENT_Q15A
First Name:
Long Answer Length = 25
ENTRY (ENT) - Question identifier:ENT_Q15B
Last name:
Long Answer Length = 25
ENTRY (ENT) - Question identifier:ENT_Q15C
Address (number and street):
Long Answer Length = 80
ENTRY (ENT) - Question identifier:ENT_Q15D
City/Town:
Long Answer Length = 30
ENTRY (ENT) - Question identifier:ENT_Q15E
Province, territory or other:
- 10: Newfoundland and Labrador
- 11: Prince Edward Island
- 12: Nova Scotia
- 13: New Brunswick
- 24: Quebec
- 35: Ontario
- 46: Manitoba
- 47: Saskatchewan
- 48: Alberta
- 59: British Columbia
- 60: Yukon
- 61: Northwest Territories
- 62: Nunavut
- 76: United States
- 77: Outside of Canada and United States
ENTRY (ENT) - Question identifier:ENT_Q15F
Telephone number (including area code):
Long Answer Length = 12
ENTRY (ENT) - Question identifier:ENT_Q20
Please enter your current age.
Min = 0; Max = 121
ENTRY (ENT) - Question identifier:ENT_R25
You indicated that you are completing this survey on behalf of [First Name]. Please provide your name and telephone number. A Statistics Canada interviewer may need to contact you for additional information.
ENTRY (ENT) - Question identifier:ENT_Q25A
First name:
Long Answer Length = 25
ENTRY (ENT) - Question identifier:ENT_Q25B
Last name:
Long Answer Length = 25
ENTRY (ENT) - Question identifier:ENT_Q25C
Telephone number (including area code):
Long Answer Length = 12
SEX AND GENDER (GDR)
SEX AND GENDER (GDR) - Question identifier:GDR_R05
The following questions are about sex at birth and gender.
SEX AND GENDER (GDR) - Question identifier:GDR_Q05
What was your sex at birth?
- 1: Male
- 2: Female
SEX AND GENDER (GDR) - Question identifier:GDR_Q10
What is your gender?
- 1: Male
- 2: Female
- 3: Or please specify
SEX AND GENDER (GDR) - Question identifier:GDR_R15
Please verify that all of the information is correct.
Your information
Sex assigned at birth: [Sex]
Gender: [Gender]
DISABILITY SCREENING QUESTIONS (DSQ)
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_R005
The following questions are about difficulties a person may have doing certain activities. Only difficulties or long-term conditions that have lasted or are expected to last for six months or more should be considered.
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q005
Do you have any difficulty seeing (even when wearing glasses or contact lenses)?
- 1: No
- 2: Sometimes
- 3: Often
- 4: Always
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q010
Do you have any difficulty hearing (even when using a hearing aid)?
- 1: No
- 2: Sometimes
- 3: Often
- 4: Always
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q015
Do you have any difficulty walking, using stairs, using your hands or fingers or doing other physical activities?
- 1: No
- 2: Sometimes
- 3: Often
- 4: Always
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q020
Do you have any difficulty learning, remembering or concentrating?
- 1: No
- 2: Sometimes
- 3: Often
- 4: Always
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q025
Do you have any emotional, psychological or mental health conditions?
- 1: No
- 2: Sometimes
- 3: Often
- 4: Always
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q030
Do you have any other health problem or long-term condition that has lasted or is expected to last for six months or more?
- 1: No
- 2: Sometimes
- 3: Often
- 4: Always
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q035
Do you wear glasses or contact lenses to improve your vision?
- 1: Yes
- 2: No
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q040
[With your glasses or contact lenses, which/Which] of the following best describes your ability to see?
- 1: No difficulty seeing
- 2: Some difficulty seeing
- 3: A lot of difficulty seeing
- 4: You are legally blind
- 5: You are blind
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q045
At what age did you begin having [difficulty seeing/a seeing condition]?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q050
How often does this [difficulty seeing/seeing condition] limit your daily activities?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q055
At what age did this [difficulty seeing/seeing condition] begin to limit your daily activities?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q060
Do you use a hearing aid or cochlear implant?
- 1: Yes
- 2: No
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q065
[With your hearing aid or cochlear implant, which/Which] of the following best describes your ability to hear?
- 1: No difficulty hearing
- 2: Some difficulty hearing
- 3: A lot of difficulty hearing
- 4: You cannot hear at all
- 5: You are Deaf
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q070
At what age did you begin having [difficulty hearing/a hearing condition]?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q075
How often does this [difficulty hearing/hearing condition] limit your daily activities?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q080
At what age did this [difficulty hearing/hearing condition] begin to limit your daily activities?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_R085
The following questions are about your ability to move around, even when using an aid such as a cane. Only difficulties or long-term conditions that have lasted or are expected to last for six months or more should be considered. Only consider aids that provide minimal support such as a cane, walking stick or crutches.
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q085
How much difficulty do you have walking on a flat surface for 15 minutes without resting?
- 1: No difficulty
- 2: Some difficulty
- 3: A lot of difficulty
- 4: You cannot do at all
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q090
How much difficulty do you have walking up or down a flight of stairs, about 12 steps without resting?
- 1: No difficulty
- 2: Some difficulty
- 3: A lot of difficulty
- 4: You cannot do at all
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q095
At what age did you begin having [difficulty walking on flat surfaces/difficulty using the stairs/difficulty walking on flat surfaces and using stairs]?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q100
How often [does this difficulty walking/does this difficulty using stairs/do these difficulties] limit your daily activities?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q105
At what age did [this difficulty walking/this difficulty using stairs/these difficulties walking and using stairs] begin to limit your daily activities?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_R110
The next questions deal with flexibility and dexterity. Only difficulties or long-term conditions that have lasted or are expected to last for six months or more should be considered.
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q110
How much difficulty do you have bending down and picking up an object from the floor?
- 1: No difficulty
- 2: Some difficulty
- 3: A lot of difficulty
- 4: You cannot do at all
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q115
How much difficulty do you have reaching in any direction, for example, above your head?
- 1: No difficulty
- 2: Some difficulty
- 3: A lot of difficulty
- 4: You cannot do at all
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q120
At what age did you begin having [difficulty bending and picking up an object/difficulty reaching/difficulty bending and picking up an object and difficulty reaching]?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q125
How often [does this difficulty bending and picking up an object/does this difficulty reaching/do these difficulties] limit your daily activities?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q130
At what age did [this difficulty bending and picking up an object/this difficulty reaching/these difficulties bending and picking up an object and reaching] begin to limit your daily activities?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q135
How much difficulty do you have using your fingers to grasp small objects like a pencil or scissors?
- 1: No difficulty
- 2: Some difficulty
- 3: A lot of difficulty
- 4: You cannot do at all
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q140
At what age did you begin having difficulty using your fingers to grasp small objects?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q145
How often does this difficulty using your fingers limit your daily activities?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q150
At what age did this difficulty using your fingers to grasp small objects begin to limit your daily activities?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_R155
The following questions are about pain due to a long-term condition that has lasted or is expected to last for six months or more.
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q155
Do you have pain that is always present?
- 1: Yes
- 2: No
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q160
Do you [also/blank] have periods of pain that reoccur from time to time?
- 1: Yes
- 2: No
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q165
At what age did you begin having this pain?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q170
How often does this pain limit your daily activities?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q175
At what age did this pain begin to limit your daily activities?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q180
When you are experiencing this pain, how much difficulty do you have with your daily activities?
- 1: No difficulty
- 2: Some difficulty
- 3: A lot of difficulty
- 4: You cannot do most activities
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q185
Do you think you have a condition that makes it difficult in general for you to learn? This may include learning disabilities such as dyslexia, hyperactivity, attention problems, etc.
- 1: Yes
- 2: No
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q190
Has a teacher, doctor or other health care professional ever said that you had a learning disability?
- 1: Yes
- 2: No
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q195
At what age did you begin having a condition that makes it difficult in general for you to learn?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q200
How often are your daily activities limited by this condition?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q205
At what age did this learning condition begin to limit your daily activities?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q210
How much difficulty do you have with your daily activities because of this condition?
- 1: No difficulty
- 2: Some difficulty
- 3: A lot of difficulty
- 4: You cannot do most activities
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q215
Has a doctor, psychologist or other health care professional ever said that you had a developmental disability or disorder? This may include Down syndrome, autism, Asperger syndrome, mental impairment due to lack of oxygen at birth, etc.
- 1: Yes
- 2: No
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q220
At what age were you diagnosed with a developmental disability or disorder?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q225
How often are your daily activities limited by this condition?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q230
At what age did this developmental disability or disorder begin to limit your daily activities?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q235
How much difficulty do you have with your daily activities because of this condition?
- 1: No difficulty
- 2: Some difficulty
- 3: A lot of difficulty
- 4: You cannot do most activities
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_R240
Again, please answer for any conditions that have lasted or are expected to last for six months or more. Please remember that your answers will be kept strictly confidential.
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q240
Do you have any emotional, psychological or mental health conditions?
- 1: Yes
- 2: No
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q245
[You mentioned earlier that you have an emotional, psychological or mental health condition./blank] At what age did your [condition/emotional, psychological or mental health condition] begin?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q250
How often are your daily activities limited by this condition?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q255
At what age did this mental health condition begin to limit your daily activities?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q260
When you are experiencing this condition, how much difficulty do you have with your daily activities?
- 1: No difficulty
- 2: Some difficulty
- 3: A lot of difficulty
- 4: You cannot do most activities
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q265
Do you have any ongoing memory problems or periods of confusion?
- 1: Yes
- 2: No
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q270
At what age did you begin having memory problems?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q275
How often are your daily activities limited by this problem?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q280
At what age did these memory problems begin to limit your daily activities?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q285
How much difficulty do you have with your daily activities because of this problem?
- 1: No difficulty
- 2: Some difficulty
- 3: A lot of difficulty
- 4: You cannot do most activities
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q290
Do you have any other health problem or long-term condition that has lasted or is expected to last for six months or more?
- 1: Yes Specify the other health problem or long-term condition
- 2: No
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q295
At what age did you begin having this health problem or condition?
Min = 0; Max = 121
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q300
How often does this health problem or condition limit your daily activities?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
- 9: DK
DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q305
At what age did this health problem or condition begin to limit your daily activities?
Min = 0; Max = 121
EPISODIC DISABILITIES (EPD)
EPISODIC DISABILITIES (EPD) - Question identifier:EPD_R05
The next questions deal with changes that you may or may not be experiencing with the impact of your conditions over time. Consider the impact of all conditions or limitations that you have.
EPISODIC DISABILITIES (EPD) - Question identifier:EPD_Q05
Do you ever have periods of one month or more when you do not feel limited in your daily activities due to your overall condition?
- 1: Yes
- 2: No
EPISODIC DISABILITIES (EPD) - Question identifier:EPD_Q10
Which of the following describes your ability to do your daily activities?
- 1: Getting better
- 2: Getting worse
- 3: Staying about the same
- 4: You are able to do more activities during some periods but fewer activities during other periods
EPISODIC DISABILITIES (EPD) - Question identifier:EPD_Q15
When you do feel limited, how long do these periods usually last?
- 1: Hours
- 2: Days
- 3: One to three weeks
- 4: A month
- 5: Two to eleven months
- 6: A year or more
EPISODIC DISABILITIES (EPD) - Question identifier:EPD_Q20
You indicated that you never [go] one month without feeling limited. Do you ever have any shorter periods of time, such as hours, days or weeks, when you do not feel limited due to your overall condition?
- 1: Yes
- 2: No
EPISODIC DISABILITIES (EPD) - Question identifier:EPD_Q25
When you do not feel limited, how long do these periods usually last?
- 1: Hours
- 2: Days
- 3: A week
- 4: Two to three weeks
EPISODIC DISABILITIES (EPD) - Question identifier:EPD_Q30
Does the intensity of your limitation vary?
- 1: No, it is usually about the same
- 2: Yes, there is usually some variation
- 3: Yes, there is usually a great deal of variation
- 9: DK
EPISODIC DISABILITIES (EPD) - Question identifier:EPD_Q35
Now thinking about when you do feel limited, does the intensity of your limitation vary?
- 1: No, it is usually about the same
- 2: Yes, there is usually some variation
- 3: Yes, there is usually a great deal of variation
- 9: DK
EPISODIC DISABILITIES (EPD) - Question identifier:EPD_Q40
You indicated that, at the current time, [your ability to do daily activities is getting better/your ability to do daily activities is getting worse/your ability to do daily activities is staying about the same/you are able to do more activities during some periods but fewer during other periods]. Thinking about the future, which of the following statements best describes how you think your limitations with daily activities will be five years from now?
- 1: [My] limitations will likely be gone
- 2: [My] limitations will likely lessen, but not be gone
- 3: [My] limitations will likely be about the same as now
- 4: [My] limitations will likely become greater
- 5: Things are so unpredictable that [I don't] know what to expect in the future
- 9: DK
MAIN CONDITION (MC)
MAIN CONDITION (MC) - Question identifier:MC_R05
You indicated earlier that you have a condition or health problem that limits your daily activities.
MAIN CONDITION (MC) - Question identifier:MC_Q05
What is the main medical condition which causes you the most difficulty or limits your activities the most?
Long Answer Length = 80
MAIN CONDITION (MC) - Question identifier:MC_Q10
Is the cause of your main condition work-related?
- 1: Yes
- 2: No
- 9: DK
MAIN CONDITION (MC) - Question identifier:MC_Q15
Which of the following describe this work-related cause?
- 1: Work accident or injury
- 2: Stress or trauma
- 3: Abuse or violence
- 4: Exposure to loud noises
- 5: Exposure to toxins, chemicals or poor air quality
- 6: Undetermined cause
- 7: Other work-related cause
- 9: DK
MAIN CONDITION (MC) - Question identifier:MC_Q15A
Is this a repetitive motion injury?
- 1: Yes
- 2: No
MAIN CONDITION (MC) - Question identifier:MC_Q20
Is the cause of your main condition [also/blank] non-work-related?
- 1: Yes
- 2: No
- 9: DK
MAIN CONDITION (MC) - Question identifier:MC_Q25
Which of the following describe this non-work-related cause?
- 01: Evident at birth
- 02: Hereditary (i.e., genetic)
- 03: Disease or illness
- 04: Stress or trauma
- 05: Abuse or violence
- 06: Exposure to loud noises
- 07: Exposure to toxins, chemicals or poor air quality
- 08: Motor vehicle accident or injury
- 09: Other type of accident or injury
- 10: Aging
- 11: Lifestyle
- 12: Undetermined cause
- 13: Other non-work-related cause
- 99: DK
MAIN CONDITION (MC) - Question identifier:MC_Q30
Do you have a second condition that causes you difficulty or limits your activities?
- 1: Yes
- 2: No
MAIN CONDITION (MC) - Question identifier:MC_Q35
What is that condition?
Long Answer Length = 80
MAIN CONDITION (MC) - Question identifier:MC_Q40
Is the cause of your second condition work-related?
- 1: Yes
- 2: No
- 9: DK
MAIN CONDITION (MC) - Question identifier:MC_Q45
Which of the following describe this work-related cause?
- 1: Work accident or injury
- 2: Stress or trauma
- 3: Abuse or violence
- 4: Exposure to loud noises
- 5: Exposure to toxins, chemicals or poor air quality
- 6: Undetermined cause
- 7: Other work-related cause
- 9: DK
MAIN CONDITION (MC) - Question identifier:MC_Q45A
Is this a repetitive motion injury?
- 1: Yes
- 2: No
MAIN CONDITION (MC) - Question identifier:MC_Q50
Is the cause of your second condition [also/blank] non-work-related?
- 1: Yes
- 2: No
- 9: DK
MAIN CONDITION (MC) - Question identifier:MC_Q55
Which of the following describe this non-work-related cause?
- 01: Evident at birth
- 02: Hereditary (i.e., genetic)
- 03: Disease or illness
- 04: Stress or trauma
- 05: Abuse or violence
- 06: Exposure to loud noises
- 07: Exposure to toxins, chemicals or poor air quality
- 08: Motor vehicle accident or injury
- 09: Other type of accident or injury
- 10: Aging
- 11: Lifestyle
- 12: Undetermined cause
- 13: Other non-work-related cause
- 99: DK
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH)
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH) - Question identifier:AADH_R05
Now, some questions about assistive aids, devices or technologies that you may use to help with a hearing condition.
Assistive aids, devices or technologies are devices or tools designed or adapted to help a person perform a particular task or activity.
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH) - Question identifier:AADH_Q05
Because of your condition, do you use any of the following?
- 01: Hearing aid
- 02: Cochlear implant or other implant
- 03: Closed captioning or subtitles for television or movies
- 04: Visual or vibrating alarms or alerts
- 05: Amplifiers (e.g., FM, loop systems or infra-red)
- 06: Video relay services (VRS)
- 07: Telephone-related devices (e.g., volume controllers, flashers or TTY)
- 08: Video chatting or video calling
- 09: Other assistive aid, device or technology Specify other assistive aid, device or technology
- 10: None
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH) - Question identifier:AADH_Q10
Are there any assistive aids, devices or technologies for a hearing condition that you think you need but do not have?
- 1: Yes
- 2: No
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH) - Question identifier:AADH_Q15
Which assistive aids, devices or technologies do you need but do not have?
- 01: Hearing aid
- 02: Cochlear implant or other implant
- 03: Closed captioning or subtitles for television or movies
- 04: Visual or vibrating alarms or alerts
- 05: Amplifiers (e.g., FM, loop systems or infra-red)
- 06: Video relay services (VRS)
- 07: Telephone-related devices (e.g., volume controllers, flashers or TTY)
- 08: Video chatting or video calling
- 09: Other assistive aid, device or technology Specify other assistive aid, device or technology
- 10: None
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH) - Question identifier:AADH_Q20
Why do you not have a hearing aid?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH) - Question identifier:AADH_Q25
Why do you not have a cochlear implant or other implant?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH) - Question identifier:AADH_Q30
Why do you not have closed captioning or subtitles for television or movies?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH) - Question identifier:AADH_Q35
Why do you not have visual or vibrating alarms or alerts?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH) - Question identifier:AADH_Q40
Why do you not have amplifiers?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH) - Question identifier:AADH_Q45
Why do you not have video relay services (VRS)?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH) - Question identifier:AADH_Q50
Why do you not have telephone-related devices?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH) - Question identifier:AADH_Q55
Why do you not have video chatting or video calling?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH) - Question identifier:AADH_Q60
Why do you not have [AADH_Q15 Category 09 response/the other assistive aid, device or technology]?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH) - Question identifier:AADH_R65
The next questions ask about ways you may communicate to help with a hearing condition.
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH) - Question identifier:AADH_Q65
Do you lip read?
- 1: Yes
- 2: No
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH) - Question identifier:AADH_Q70
Do you use sign language such as ASL or LSQ?
- 1: Yes
- 2: No
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH) - Question identifier:AADH_Q75
How often do you use sign language?
- 1: Every day
- 2: At least once a week
- 3: At least once a month
- 4: At least once every six months
- 5: Less than once every six months
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH) - Question identifier:AADH_Q80
Do you ever use a sign language interpreter?
- 1: Yes
- 2: No
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - HEARING (AADH) - Question identifier:AADH_Q85
How often do you use a sign language interpreter?
- 1: Every day
- 2: At least once a week
- 3: At least once a month
- 4: At least once every six months
- 5: Less than once every six months
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - VISION (AADV)
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - VISION (AADV) - Question identifier:AADV_R05
Now some questions about assistive aids, devices or technologies that you may use to help with a seeing condition.
Assistive aids, devices or technologies are devices or tools designed or adapted to help a person perform a particular task or activity.
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - VISION (AADV) - Question identifier:AADV_Q05
Because of your condition, do you use any of the following?
- 01: Eye glasses or contact lenses
- 02: White cane (e.g., identification cane, support cane, mobility cane, long cane)
- 03: Recording equipment (Exclude recording features on a cell phone or smartphone.)
- 04: Braille Refreshable Display device, braille notetaker, braille reading materials or manual brailler
- 05: Magnifiers (Exclude screen magnification software.)
- 06: Large print reading materials
- 07: Dark lined paper or dark ink pens
- 08: Device with oversized buttons or oversized print on buttons (e.g., remote control or telephone)
- 09: Audio or described video for television programs
- 10: Closed-circuit devices (e.g., CCTV)
- 11: Low-tech vision aides (e.g., monocular, binocular, biopics, etc.)
- 12: Talking products (e.g., GPS navigation device, watch, kitchen timer, alarm clock, etc.)
- 13: Other assistive aid, device or technology Specify other assistive aid, device or technology
- 14: None
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - VISION (AADV) - Question identifier:AADV_Q10
Are there any assistive aids, devices or technologies for a seeing condition that you think you need but do not have?
- 1: Yes
- 2: No
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - VISION (AADV) - Question identifier:AADV_Q15
Which assistive aids, devices or technologies do you need but do not have?
- 01: Eye glasses or contact lenses
- 02: White cane (e.g., identification cane, support cane, mobility cane, long cane)
- 03: Recording equipment (Exclude recording features on a cell phone or smartphone.)
- 04: Braille Refreshable Display device, braille notetaker, braille reading materials or manual brailler
- 05: Magnifiers (Exclude screen magnification software.)
- 06: Large print reading materials
- 07: Dark lined paper or dark ink pens
- 08: Device with oversized buttons or oversized print on buttons (e.g., remote control or telephone)
- 09: Audio or described video for television programs
- 10: Closed-circuit devices (e.g., CCTV)
- 11: Low-tech vision aides (e.g., monocular, binocular, biopics, etc.)
- 12: Talking products (e.g., GPS navigation device, watch, kitchen timer, alarm clock, etc.)
- 13: Other assistive aid, device or technology Specify other assistive aid, device or technology
- 14: None
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - VISION (AADV) - Question identifier:AADV_Q20
Why do you not have eye glasses or contact lenses?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - VISION (AADV) - Question identifier:AADV_Q25
Why do you not have a white cane?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - VISION (AADV) - Question identifier:AADV_Q30
Why do you not have recording equipment?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - VISION (AADV) - Question identifier:AADV_Q35
Why do you not have a Braille Refreshable Display device, braille note taker, braille reading materials or manual brailler?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - VISION (AADV) - Question identifier:AADV_Q40
Why do you not have magnifiers?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - VISION (AADV) - Question identifier:AADV_Q45
Why do you not have large print reading materials?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - VISION (AADV) - Question identifier:AADV_Q50
Why do you not have dark lined paper or dark ink pens?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - VISION (AADV) - Question identifier:AADV_Q55
Why do you not have a device with oversized buttons or oversized print on buttons?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - VISION (AADV) - Question identifier:AADV_Q60
Why do you not have audio or described video for television programs?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - VISION (AADV) - Question identifier:AADV_Q65
Why do you not have closed-circuit devices?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - VISION (AADV) - Question identifier:AADV_Q70
Why do you not have low-tech vision aids?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - VISION (AADV) - Question identifier:AADV_Q75
Why do you not have talking products?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - VISION (AADV) - Question identifier:AADV_Q80
Why do you not have [AADV_Q15 Category 13 response/the other assistive aid, device or technology]?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM)
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_R005
Now some questions about assistive aids, devices or technologies that you may use for moving around, to help with bending or reaching or to help with fine motor skills.
Assistive aids, devices or technologies are devices or tools designed or adapted to help a person perform a particular task or activity.
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q005
Because of your condition, do you use any of the following?
- 01: Cane, walking stick or crutches
- 02: Walker
- 03: Scooter
- 04: Manual wheelchair
- 05: Motorized wheelchair
- 06: Orthopaedic footwear (e.g., shoes, sandals, etc.)
- 07: Orthotic or brace
- 08: Prosthetic device or artificial limb
- 09: Grasping tool or reach extender
- 10: Adapted tools, utensils or special grips
- 11: Device for dressing (e.g., button hook, zipper pull, long-handled shoe horn)
- 12: Device with oversized buttons (e.g., remote control or telephone)
- 13: None
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_R010
The next questions are about assistive aids, devices or technologies and accessibility features you may use in your residence to help with moving around, to help with bending or reaching or to help with fine motor skills.
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q010
Because of your condition, at your residence, do you use any of the following?
- 01: Bathroom aids (e.g., raised toilet seat, grab bars, shower or bathtub chair)
- 02: Walk-in bath or shower
- 03: Patient lift (e.g., Hoyer lift, sling, sit to stand)
- 04: Access ramp or a ground-level entrance
- 05: Elevator, stair lift or a platform or porch lift
- 06: Automatic or easy to open doors
- 07: Extra railings (other than on stairs)
- 08: None
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q015
Because of your condition, at your residence, do you have any of the following?
- 1: Widened doorways or hallways
- 2: Adjusted (lowered or raised) counters in the kitchen or bathroom
- 3: None
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q020A
Do you use any other assistive aid, device or technology or accessibility feature for moving around, to help with bending or reaching or to help with fine motor skills?
- 1: Yes
- 2: No
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q020B
What is the other assistive aid, device or technology that you use?
Long Answer Length = 80
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q025
Are there any assistive aids, devices or technologies for moving around, to help with bending or reaching or to help with fine motor skills that you think you need but do not have?
- 1: Yes
- 2: No
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q030
Which of the following assistive aids, devices or technologies do you need but do not have?
- 01: Cane, walking stick or crutches
- 02: Walker
- 03: Scooter
- 04: Manual wheelchair
- 05: Motorized wheelchair
- 06: Orthopaedic footwear (e.g., shoes, sandals, etc.)
- 07: Orthotic or brace
- 08: Prosthetic device or artificial limb
- 09: Grasping tool or reach extender
- 10: Adapted tools, utensils or special grips
- 11: Device for dressing (e.g., button hook, zipper pull, long-handled shoe horn)
- 12: Device with oversized buttons (e.g., remote control or telephone)
- 13: Bathroom aids (e.g., raised toilet seat, grab bars, shower or bathtub chair)
- 14: Walk-in bath or shower
- 15: Patient lift (e.g., Hoyer lift, sling, sit to stand)
- 16: Access ramp or a ground-level entrance
- 17: Elevator, stair lift or a platform or porch lift
- 18: Automatic or easy to open doors
- 19: Extra railings (other than on stairs)
- 20: Widened doorways or hallways
- 21: Adjusted (lowered or raised) counters in the kitchen or bathroom
- 22: Other assistive aid, device or technology Specify other assistive aid, device or technology
- 23: None
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q035
Why do you not have a cane, walking stick or crutches?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q040
Why do you not have a walker?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q045
Why do you not have a scooter?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q050
Why do you not have a manual wheelchair?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q055
Why do you not have a motorized wheelchair?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q060
Why do you not have orthopaedic footwear?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q065
Why do you not have an orthotic or brace?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q070
Why do you not have a prosthetic device or artificial limb?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q075
Why do you not have a grasping tool or reach extender?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q080
Why do you not have adapted tools, utensils or special grips?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q085
Why do you not have a device for dressing?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q090
Why do you not have a device with oversized buttons?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q095
Why do you not have bathroom aids?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q100
Why do you not have a walk-in bath or shower?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q105
Why do you not have a patient lift?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q110
Why do you not have an access ramp or a ground-level entrance?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q115
Why do you not have an elevator, a stair lift or a platform or porch lift?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q120
Why do you not have automatic or easy to open doors?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q125
Why do you not have extra railings (other than on stairs)?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q130
Why do you not have widened doorways or hallways?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q135
Why do you not have adjusted (lowered or raised) counters in the kitchen or bathroom?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q140
Why do you not have [AADM_Q030 Category 22 response/the other assistive aid, device or technology]?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - LEARNING AND DEVELOPMENTAL (AADL)
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - LEARNING AND DEVELOPMENTAL (AADL) - Question identifier:AADL_R05
Now some questions about assistive aids, devices or technologies that you may use to help with learning or developmental difficulties.
Assistive aids, devices or technologies are devices or tools designed or adapted to help a person perform a particular task or activity.
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - LEARNING AND DEVELOPMENTAL (AADL) - Question identifier:AADL_Q05
Because of your condition, do you use any of the following?
- 01: Recording equipment or a portable note-taking device
- 02: Reading aids (e.g., reading focus cards, optical character recognition (OCR), etc.)
- 03: Writing and spelling aids (e.g., portable spell checker, abbreviation expanders, electronic dictionary, word prediction software, etc.)
- 04: Math aids (e.g., electronic math worksheets, talking calculator, etc.)
- 05: Alternative keyboard with overlays
- 06: Bliss board
- 07: Other assistive aid, device or technology Specify other assistive aid, device or technology
- 08: None
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - LEARNING AND DEVELOPMENTAL (AADL) - Question identifier:AADL_Q10
Are there any assistive aids, devices or technologies for learning that you think you need but do not have?
- 1: Yes
- 2: No
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - LEARNING AND DEVELOPMENTAL (AADL) - Question identifier:AADL_Q15
Which assistive aids, devices or technologies do you need but do not have?
- 01: Recording equipment or a portable note-taking device
- 02: Reading aids (e.g., reading focus cards, optical character recognition (OCR), etc.)
- 03: Writing and spelling aids (e.g., portable spell checker, abbreviation expanders, electronic dictionary, word prediction software, etc.)
- 04: Math aids (e.g., electronic math worksheets, talking calculator, etc.)
- 05: Alternative keyboard with overlays
- 06: Bliss board
- 07: Other assistive aid, device or technology Specify other assistive aid, device or technology
- 08: None
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - LEARNING AND DEVELOPMENTAL (AADL) - Question identifier:AADL_Q20
Why do you not have recording equipment or a portable note-taking device?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - LEARNING AND DEVELOPMENTAL (AADL) - Question identifier:AADL_Q25
Why do you not have reading aids?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - LEARNING AND DEVELOPMENTAL (AADL) - Question identifier:AADL_Q30
Why do you not have writing and spelling aids?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - LEARNING AND DEVELOPMENTAL (AADL) - Question identifier:AADL_Q35
Why do you not have math aids?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - LEARNING AND DEVELOPMENTAL (AADL) - Question identifier:AADL_Q40
Why do you not have an alternative keyboard with overlays?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - LEARNING AND DEVELOPMENTAL (AADL) - Question identifier:AADL_Q45
Why do you not have a Bliss board?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - LEARNING AND DEVELOPMENTAL (AADL) - Question identifier:AADL_Q50
Why do you not have [AADL_Q15 Category 07 response/the other assistive aid, device or technology]?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA)
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_R005A
The following questions are about various assistive aids, devices or technologies that you may use for any of your conditions.
You may feel that some of these questions do not apply to you or may seem similar to questions already asked, but it is important that we ask the same questions of everyone.
Please exclude medication taken for your conditions, as this is included in a later section.
Assistive aids, devices or technologies are devices or tools designed or adapted to help a person perform a particular task or activity.
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_R005B
Because of your condition, do you use any of the following?
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q005A
A. A cell phone, smartphone or smartwatch with specialized features or apps to help with your condition
- 1: Yes
- 2: No
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q005B
B. A computer, laptop or tablet with specialized software or apps or other adaptations to help with your condition
- 1: Yes
- 2: No
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q010
Because of your condition, do you use speech to text, text to speech or voice recognition software?
- 1: Yes
- 2: No
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q015
Because of your condition, do you use screen magnification software?
- 1: Yes
- 2: No
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q020
Because of your condition, do you use a screen reader?
- 1: Yes
- 2: No
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q025
Because of your condition, do you use any other specialized software or apps or adaptations on your devices to help with a condition?
- 1: Yes
- 2: No
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q030
Because of your condition, do you use a device for playing audio books or e-books?
- 1: Yes
- 2: No
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q035
Are audio books or e-books generally available in an accessible format for your condition?
- 1: Yes
- 2: No
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q040
Because of your condition, do you use any of the following?
- 01: Service animal (e.g., guide, hearing ear or mobility dog, specially-trained emotional support or therapy animal)
- 02: Orthopaedic footwear (e.g., shoes, sandals, etc.)
- 03: Orthotic or brace
- 04: Supportive devices (e.g., therapeutic cushions or pillows, special chairs or an adjustable bed)
- 05: Electrotherapy device for pain (e.g., TENS machine)
- 06: Voice amplifier
- 07: Diabetic aids (e.g., blood glucose monitor or needles)
- 08: Oxygen supplies
- 09: Smart home devices (e.g., Google Home, Amazon Echo (Alexa), smart lights or thermostats, etc.)
- 10: Other assistive aid, device or technology Specify other assistive aid, device or technology
- 11: None
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q045
Are there any assistive aids, devices or technologies or specialized equipment that you think you need but do not have?
- 1: Yes
- 2: No
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q050
Which assistive aids, devices or technologies or specialized equipment do you need but do not have?
- 01: Cell phone, smartphone or smartwatch with specialized features or apps
- 02: Computer, laptop or tablet with specialized software or apps or other adaptations
- 03: Speech to text, text to speech or voice recognition software
- 04: Screen magnification software
- 05: Screen reader
- 06: Other software or apps or adaptations on your devices to help with a condition
- 07: Device for playing audio books or e-books
- 08: Service animal (e.g., guide, hearing or mobility dog, specially-trained emotional support or therapy animal)
- 09: Orthopaedic footwear (e.g., shoes, sandals, etc.)
- 10: Orthotic or brace
- 11: Supportive devices (e.g., therapeutic cushions or pillows, special chairs or an adjustable bed)
- 12: Electrotherapy device for pain (e.g., TENS machine)
- 13: Voice amplifier
- 14: Diabetic aids (e.g., blood glucose monitor or needles)
- 15: Oxygen supplies
- 16: Smart home devices (e.g., Google Home, Amazon Echo (Alexa), smart lights or thermostats, etc.)
- 17: Other assistive aid, device or technology Specify other assistive aid, device or technology
- 18: None
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q055
Why do you not have a cellphone, smartphone or smartwatch with specialized features or apps?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q060
Why do you not have a computer, laptop or tablet with specialized software or apps or other adaptations?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q065
Why do you not have speech to text, text to speech or voice recognition software?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q070
Why do you not have screen magnification software?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q075
Why do you not have a screen reader?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q080
Why do you not have other software or apps or adaptations on your devices to help with a condition?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q085
Why do you not have a device for playing audio books or e-books?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q090
Why do you not have a service animal?
- 1: Cost
- 2: Do not want one
- 3: Not available (e.g., unsure how or where to get one, not available locally, on a waiting list, etc.)
- 4: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q095
Why do you not have orthopaedic footwear?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q100
Why do you not have an orthotic or brace?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q105
Why do you not have supportive devices?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q110
Why do you not have an electrotherapy device for pain?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q115
Why do you not have a voice amplifier?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q120
Why do you not have diabetic aids?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q125
Why do you not have oxygen supplies?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q130
Why do you not have smart home devices?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q135
Why do you not have [AADA_Q050 Category 17 response/the other assistive aid, device or technology]?
- 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
- 2: Do not want to or not willing to upgrade from current aid or assistive device
- 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
- 4: Available aids cannot be adapted
- 5: Other reasons
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q140
Thinking of all the assistive aids, devices or technologies that you use because of your condition, in the past 12 months, did you have any expenses for the purchase, repair or maintenance of your assistive aids, devices or technologies for which you will not be reimbursed?
- 1: Yes
- 2: No
ASSISTIVE AIDS, DEVICES OR TECHNOLOGIES - ALL (AADA) - Question identifier:AADA_Q145
What is the total amount of these expenses for which you will not be reimbursed?
- 1: Less than $100
- 2: $100 to less than $200
- 3: $200 to less than $500
- 4: $500 to less than $1,000
- 5: $1,000 to less than $2,000
- 6: $2,000 to less than $5,000
- 7: $5,000 or more
- 9: DK
MEDICATION USE (MED)
MEDICATION USE (MED) - Question identifier:MED_R05
The next questions are about the use of prescription medications taken for any conditions that have lasted or are expected to last for six months or more.
MEDICATION USE (MED) - Question identifier:MED_Q05
Because of your condition, do you take any prescription medications at least once a week?
- 1: Yes
- 2: No
MEDICATION USE (MED) - Question identifier:MED_Q10
Because of your condition, do you [also/blank] take any prescription medications less often than once a week such as monthly or every few months?
- 1: Yes
- 2: No
MEDICATION USE (MED) - Question identifier:MED_Q15
In the past 12 months, were you ever unable to get prescription medications you were supposed to take because of the cost?
- 1: Yes
- 2: No
MEDICATION USE (MED) - Question identifier:MED_Q20
In the past 12 months, did you ever take prescription medication less often than you were supposed to because of the cost?
- 1: Yes
- 2: No
MEDICATION USE (MED) - Question identifier:MED_Q25
Thinking of all the prescription medications you have taken in the past 12 months, did you have any expenses for prescription medications, for which you will not be reimbursed?
- 1: Yes
- 2: No
- 3: Have not taken any prescription medications in the past 12 months
MEDICATION USE (MED) - Question identifier:MED_Q30
What is the amount of these expenses for which you will not be reimbursed?
- 1: Less than $500
- 2: $500 to less than $1,000
- 3: $1,000 to less than $2,000
- 4: $2,000 to less than $5,000
- 5: $5,000 to less than $7,500
- 6: $7,500 to less than $10,000
- 7: $10,000 or more
- 9: DK
CANNABIS USE (CAN)
CANNABIS USE (CAN) - Question identifier:CAN_R05
The next questions are about the use of cannabis for medical purposes. The term "cannabis" refers to marijuana, hashish, hash oil, CBD oil or any other product of the cannabis plant.
CANNABIS USE (CAN) - Question identifier:CAN_Q05
In the past 12 months, have you used cannabis for medical purposes, either with or without a medical document?
- 1: Yes
- 2: No
- 9: DK
CANNABIS USE (CAN) - Question identifier:CAN_Q10
In the past 12 months, how often did you use cannabis for medical purposes?
- 1: Once or twice
- 2: Monthly
- 3: Weekly
- 4: Daily or almost daily
- 5: Did not use cannabis in the past 12 months
- 9: DK
CANNABIS USE (CAN) - Question identifier:CAN_Q15
Do you have a medical document from a health care professional to use cannabis?
- 1: Yes
- 2: No
- 9: DK
HELP RECEIVED (HRE)
HELP RECEIVED (HRE) - Question identifier:HRE_R05
Now, some questions on help you may receive with your daily activities because of any of your conditions.
HELP RECEIVED (HRE) - Question identifier:HRE_Q05
Because of your condition, do you usually receive help with any of the following activities?
- 01: Preparing meals
- 02: Everyday housework (e.g., dusting or tidying up)
- 03: Heavy household chores (e.g., yard work, snow removal or spring cleaning)
- 04: Getting to appointments or running errands (e.g., shopping for groceries or other essential items)
- 05: Looking after personal finances (e.g., making bank transactions or paying bills)
- 06: Personal care (e.g., washing, dressing or taking medication)
- 07: Basic medical care at home (e.g., blood or urine tests, injections, etc.)
- 08: Moving around inside residence
- 09: Other type of help Specify the other type of help you usually receive
- 10: Do not receive any help
HELP RECEIVED (HRE) - Question identifier:HRE_Q10
Because of your condition, do you need more help than you usually receive with any of the following activities?
- 01: Preparing meals
- 02: Everyday housework (e.g., dusting or tidying up)
- 03: Heavy household chores (e.g., yard work, snow removal or spring cleaning)
- 04: Getting to appointments or running errands (e.g., shopping for groceries or other essential items)
- 05: Looking after personal finances (e.g., making bank transactions or paying bills)
- 06: Personal care (e.g., washing, dressing or taking medication)
- 07: Basic medical care at home (e.g., blood or urine tests, injections, etc.)
- 08: Moving around inside residence
- 09: [HRE_Q05 Category 09 response/Other type of help you usually receive]
- 10: None of the above
HELP RECEIVED (HRE) - Question identifier:HRE_Q15
Because of your condition, do you need help with any of the following activities?
- 01: Preparing meals
- 02: Everyday housework (e.g., dusting or tidying up)
- 03: Heavy household chores (e.g., yard work, snow removal or spring cleaning)
- 04: Getting to appointments or running errands (e.g., shopping for groceries or other essential items)
- 05: Looking after personal finances (e.g., making bank transactions or paying bills)
- 06: Personal care (e.g., washing, dressing or taking medication)
- 07: Basic medical care at home (e.g., blood or urine tests, injections, etc.)
- 08: Moving around inside residence
- 09: Other type of help Specify the other type of help you need
- 10: Do not need any help
HELP RECEIVED (HRE) - Question identifier:HRE_Q20
Thinking of all the help you receive with your activities because of your condition, how often do you usually receive help?
- 1: Daily
- 2: At least once a week
- 3: At least once a month
- 4: Less than once a month
HELP RECEIVED (HRE) - Question identifier:HRE_Q25
Who helps you with your activities?
- 1: Family member living with you
- 2: Family member not living with you
- 3: Friend or neighbour
- 4: Organization or individual you pay
- 5: Organization or individual you do not pay
HELP RECEIVED (HRE) - Question identifier:HRE_Q25A
Which family member living with you?
- 1: Spouse or partner
- 2: Parent or guardian
- 3: Brother or sister
- 4: Son or daughter
- 5: Other family member
HELP RECEIVED (HRE) - Question identifier:HRE_Q25B
Which family member not living with you?
- 1: Spouse or partner
- 2: Parent or guardian
- 3: Brother or sister
- 4: Son or daughter
- 5: Other family member
HELP RECEIVED (HRE) - Question identifier:HRE_Q30
Thinking of all the help you receive because of your condition, in the past 12 months, did you have any expenses for help received, for which you will not be reimbursed?
- 1: Yes
- 2: No
HELP RECEIVED (HRE) - Question identifier:HRE_Q35
What is the amount of these expenses for which you will not be reimbursed?
- 1: Less than $500
- 2: $500 to less than $1,000
- 3: $1,000 to less than $2,000
- 4: $2,000 to less than $5,000
- 5: $5,000 to less than $7,500
- 6: $7,500 to less than $10,000
- 7: $10,000 or more
- 9: DK
HEALTH CARE THERAPIES AND SERVICES (HTS)
HEALTH CARE THERAPIES AND SERVICES (HTS) - Question identifier:HTS_R05
The next questions are about the contact you have with health care and social service providers because of any of your conditions.
HEALTH CARE THERAPIES AND SERVICES (HTS) - Question identifier:HTS_Q05
During the past 12 months, did you receive any of the following therapies or services on a regular basis because of your condition?
- 01: Physiotherapy, massage therapy or chiropractic treatments
- 02: Speech therapy
- 03: Occupational therapy
- 04: Counselling services from a psychologist, psychiatrist, psychotherapist or social worker
- 05: Support group services, drop-in center services or telephone information or support lines
- 06: Life sustaining therapies or specialized medical care (e.g., injections, catheter or colostomy care, wound care, chemotherapy, dialysis, etc.)
- 07: Addiction services
- 08: Life skills program or services (e.g., learning skills for independence)
- 09: Naturopathic, homeopathic or osteopathic treatments
- 10: Acupuncture
- 11: Nutrition or dietary services
- 12: Specialized vision care from an ophthalmologist, optometrist or optician (Exclude regular eye exams.)
- 13: Other therapy or service Specify the other therapy or service received
- 14: None
HEALTH CARE THERAPIES AND SERVICES (HTS) - Question identifier:HTS_Q05A
During the past 12 months, have you spent 14 hours or more per week receiving life sustaining therapies or specialized medical care?
- 1: Yes
- 2: No
HEALTH CARE THERAPIES AND SERVICES (HTS) - Question identifier:HTS_Q10
During the past 12 months, did you need to receive more of the following therapies or services because of your condition?
- 01: Physiotherapy, massage therapy or chiropractic treatments
- 02: Speech therapy
- 03: Occupational therapy
- 04: Counselling services from a psychologist, psychiatrist, psychotherapist or social worker
- 05: Support group services, drop-in center services or telephone information or support lines
- 06: Life sustaining therapies or specialized medical care (e.g., injections, catheter or colostomy care, wound care, chemotherapy, dialysis, etc.)
- 07: Addiction services
- 08: Life skills program or services (e.g., learning skills for independence)
- 09: Naturopathic, homeopathic or osteopathic treatments
- 10: Acupuncture
- 11: Nutrition or dietary services
- 12: Specialized vision care from an ophthalmologist, optometrist or optician (Exclude regular eye exams.)
- 13: [HTS_Q05 Category13 response/Other therapy or service]
- 14: None
HEALTH CARE THERAPIES AND SERVICES (HTS) - Question identifier:HTS_Q15
Why didn't you receive more of the therapies or services that you needed?
- 1: Cost (e.g., too expensive, no or limited insurance)
- 2: No longer available
- 3: Prevented by health condition
- 4: Transportation not available
- 5: Office hours not convenient
- 6: Other reason - Specify the other reason
HEALTH CARE THERAPIES AND SERVICES (HTS) - Question identifier:HTS_Q20
During the past 12 months, which of the following therapies or services did you need on a regular basis because of your condition but did not receive?
- 01: Physiotherapy, massage therapy or chiropractic treatments
- 02: Speech therapy
- 03: Occupational therapy
- 04: Counselling services from a psychologist, psychiatrist, psychotherapist or social worker
- 05: Support group services, drop-in center services or telephone information or support lines
- 06: Life sustaining therapies or specialized medical care (e.g., injections, catheter or colostomy care, wound care, chemotherapy, dialysis, etc.)
- 07: Addiction services
- 08: Life skills program or services (e.g., learning skills for independence)
- 09: Naturopathic, homeopathic or osteopathic treatments
- 10: Acupuncture
- 11: Nutrition or dietary services
- 12: Specialized vision care from an ophthalmologist, optometrist or optician (Exclude regular eye exams.)
- 13: Other therapy or service Specify the other therapy or service that you needed but did not receive
- 14: None
HEALTH CARE THERAPIES AND SERVICES (HTS) - Question identifier:HTS_Q25
Why didn't you receive the therapies or services that you needed on a regular basis?
- 01: Cost (e.g., too expensive, no or limited insurance)
- 02: Not available in community
- 03: On a waiting list
- 04: Transportation not available
- 05: Could not get a referral
- 06: Office hours not convenient
- 07: Didn't know where or how to find them
- 08: Other reason Specify the other reason
HEALTH CARE THERAPIES AND SERVICES (HTS) - Question identifier:HTS_Q30
Thinking of all the therapies or services you receive because of your condition, in the past 12 months, did you have any expenses for therapies or services, for which you will not be reimbursed?
- 1: Yes
- 2: No
HEALTH CARE THERAPIES AND SERVICES (HTS) - Question identifier:HTS_Q35
What is the amount of these expenses for which you will not be reimbursed?
- 1: Less than $500
- 2: $500 to less than $1,000
- 3: $1,000 to less than $2,000
- 4: $2,000 to less than $5,000
- 5: $5,000 to less than $7,500
- 6: $7,500 to less than $10,000
- 7: $10,000 or more
- 9: DK
EDUCATION (EDU)
EDUCATION (EDU) - Question identifier:EDU_R05
The next questions are on education.
EDUCATION (EDU) - Question identifier:EDU_Q05
Are you currently attending a school, college, CEGEP or university?
- 1: Yes
- 2: No
EDUCATION (EDU) - Question identifier:EDU_Q10
When did you last attend school, college, CEGEP or university?
- 1: 2021 or 2022
- 2: Between 2017 and 2020
- 3: Before 2017
- 4: Never
- 9: DK
EDUCATION (EDU) - Question identifier:EDU_Q15
Did you have your condition when you were attending school?
- 1: Yes
- 2: No
EDUCATION (EDU) - Question identifier:EDU_Q20
What type of educational institution [are you attending/did you attend]?
- 1: Elementary, junior high school or high school
- 2: Trade school, college, CEGEP or other non-university institution
- 3: University
EDUCATION (EDU) - Question identifier:EDU_Q25
[Are/Were] you enrolled as a full-time or part-time student?
- 1: Full-time student
- 2: Part-time student
- 3: Both full-time and part-time student
EDUCATION (EDU) - Question identifier:EDU_Q30
[Are/Were] you studying part-time because of your condition?
- 1: Yes
- 2: No
EDUCATION (EDU) - Question identifier:EDU_Q35
Because of your condition, [do/did] you require adapted or modified building features to attend school?
- 1: Yes
- 2: No
EDUCATION (EDU) - Question identifier:EDU_Q40
[Do/Did] you require any of the following features?
- 1: Accessible classrooms
- 2: Adapted washrooms
- 3: Accessible residences
- 4: Accessible buildings, excluding residences
- 5: Another feature Specify the other feature
- 6: None of the above
EDUCATION (EDU) - Question identifier:EDU_Q45
Which of the following features were made available to you?
- 1: Accessible classrooms
- 2: Adapted washrooms
- 3: Accessible residences
- 4: Accessible buildings, excluding residences
- 5: [EDU_Q40 Category 5 response/Other features]
- 6: None of the above
EDUCATION (EDU) - Question identifier:EDU_Q50
[Do/Did] you require specialized transportation to attend school?
- 1: Yes
- 2: No
EDUCATION (EDU) - Question identifier:EDU_Q55
[Is/Was] specialized transportation available to you?
- 1: Yes
- 2: No
EDUCATION (EDU) - Question identifier:EDU_Q60
[Do/Did] you need any assistive devices, support services, modification to curriculum or additional time for testing to follow your courses?
- 1: Yes
- 2: No
EDUCATION (EDU) - Question identifier:EDU_Q65
Which of the following [do/did] you need?
- 01: Cell phone, smartphone or smartwatch with specialized features or apps to help with your condition
- 02: Computer, laptop or tablet with specialized software or apps or other adaptations to help with your condition
- 03: Recording equipment or a portable note-taking device
- 04: Device for playing audio books or e-books
- 05: Textbooks in e-format
- 06: Screen magnification software
- 07: Magnifiers
- 08: Closed-circuit devices (e.g., CCTV)
- 09: Large print reading materials
- 10: Braille Refreshable Display device, braille note taker, braille reading materials or a manual brailler
- 11: Educational assistant or tutor
- 12: Sign language interpreter
- 13: Attendant care services
- 14: Speech therapist
- 15: Special education classes
- 16: Modified or adapted course curriculum
- 17: Individualized Education Plan (e.g., IEP, PLP)
- 18: Extended time to take tests and exams
- 19: Sensory objects (e.g., fidget toys)
- 20: Quiet room or sensory room
- 21: Another aid or service Specify the other aid or service
- 22: None of the above
EDUCATION (EDU) - Question identifier:EDU_Q70
Which of the following were made available to you?
- 01: Cell phone, smartphone or smartwatch with specialized features or apps to help with your condition
- 02: Computer, laptop or tablet with specialized software or apps or other adaptations to help with your condition
- 03: Recording equipment or a portable note-taking device
- 04: Device for playing audio books or e-books
- 05: Textbooks in e-format
- 06: Screen magnification software
- 07: Magnifiers
- 08: Closed-circuit devices (e.g., CCTV)
- 09: Large print reading materials
- 10: Braille Refreshable Display device, braille note taker, braille reading materials or a manual brailler
- 11: Educational assistant or tutor
- 12: Sign language interpreter
- 13: Attendant care services
- 14: Speech therapist
- 15: Special education classes
- 16: Modified or adapted course curriculum
- 17: Individualized Education Plan (e.g., IEP, PLP)
- 18: Extended time to take tests and exams
- 19: Sensory objects (e.g., fidget toys)
- 20: Quiet room or sensory room
- 21: [EDU_Q65 Category 21 response/Other aid or service]
- 22: None of the above
EDUCATIONAL EXPERIENCES (EEX)
EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_R05
Now some questions about your experience at school.
EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q05
[Have you ever discontinued/Did you discontinue] your formal education or training because of your condition?
- 1: Yes
- 2: No
EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_R10
Because of your condition, did you experience any of the following?
EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q10A
A.Did you begin school later than most other people your age
- 1: Yes
- 2: No
EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q10B
B. Did you ever attend a special education school or special education classes in a regular school
- 1: Yes
- 2: No
EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q10C
C. Did you take fewer courses or subjects than you otherwise would have
- 1: Yes
- 2: No
EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q10D
D. Was your choice of courses or careers influenced
- 1: Yes
- 2: No
EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q10E
E. Was your education interrupted for long periods of time
- 1: Yes
- 2: No
EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q10F
F. Did you have any additional expenses for your schooling
- 1: Yes
- 2: No
EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q10G
Because of your condition, did you ever go back to school for retraining?
- 1: Yes
- 2: No
EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q15A
Because of your condition, did it take you longer to achieve your present level of education?
- 1: Yes
- 2: No
EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q15B
How much longer did it take?
Min = 0; Max = 10
EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q20
Because of your condition, did you experience bullying at school?
- 1: Yes
- 2: No
EDUCATIONAL BACKGROUND (EDB)
EDUCATIONAL BACKGROUND (EDB) - Question identifier:EDB_Q05
What is the highest certificate, diploma or degree that you have completed?
- 1: Less than high school diploma or its equivalent
- 2: High school diploma or a high school equivalency certificate
- 3: Trades certificate or diploma
- 4: College, CEGEP or other non-university certificate or diploma (other than trades certificates or diplomas)
- 5: University certificate or diploma below the bachelor's level
- 6: Bachelor's degree (e.g., B.A., B.A. (Hons), B.Sc., B.Ed., LL.B.)
- 7: University certificate, diploma or degree above the bachelor's level
- 9: DK
EDUCATIONAL BACKGROUND (EDB) - Question identifier:EDB_Q10
In what year did you complete your highest certificate, diploma or degree?
Min = 1922; Max = 2022
EDUCATIONAL BACKGROUND (EDB) - Question identifier:EDB_Q15
What was the major field of study of the highest certificate, diploma or degree you completed?
Long Answer Length = 80
LABOUR MARKET ACTIVITIES MINIMAL (LMAM)
LABOUR MARKET ACTIVITIES MINIMAL (LMAM) - Question identifier:LMAM_R01
Many of the following questions concern your activities last week. Last week is the week beginning on Sunday and ending Saturday of last week.
LABOUR MARKET ACTIVITIES MINIMAL (LMAM) - Question identifier:LMAM_Q01
Last week, did you work at a job or business?
- 1: Yes
- 2: No
- 3: Completely prevented from working
LABOUR MARKET ACTIVITIES MINIMAL (LMAM) - Question identifier:LMAM_Q02
Last week, did you have a job or business from which you were absent?
- 1: Yes
- 2: No
LABOUR MARKET ACTIVITIES MINIMAL (LMAM) - Question identifier:LMAM_Q03
What was the main reason you were absent from work last week?
- 01: Own illness or disability
- 02: Caring for own children
- 03: Caring for adult family member
- 04: Maternity or parental leave
- 05: Other personal or family responsibilities
- 06: Vacation
- 07: Labour dispute (strike or lockout) (Employees only)
- 08: Temporary layoff due to business conditions (Employees only)
- 09: Seasonal layoff (Employees only)
- 10: Casual job, no work available (Employees only)
- 11: Work schedule (e.g., 10 days on, 10 days off, employees only)
- 12: Self-employed, no work available (Self-employed only)
- 13: Seasonal business (Excluding employees.)
- 14: Other Specify the main reason you were absent from work last week
LABOUR FORCE STATUS (LMA2)
LABOUR FORCE STATUS (LMA2) - Question identifier:LMA2_Q01
Did you do anything to find work during the past four weeks?
- 1: Yes
- 2: No
LABOUR FORCE STATUS (LMA2) - Question identifier:LMA2_Q02
Last week, did you have a job to start at a definite date in the future?
- 1: Yes
- 2: No
LABOUR FORCE STATUS (LMA2) - Question identifier:LMA2_Q03
Will you start that job in the next four weeks?
- 1: Yes
- 2: No
LABOUR FORCE STATUS (LMA2) - Question identifier:LMA2_Q04
How many hours did you want to work per week?
- 1: 30 or more hours
- 2: Less than 30 hours
LABOUR FORCE STATUS (LMA2) - Question identifier:LMA2_Q05
Could you have worked last week [if you had been recalled/if a suitable job had been offered]?
- 1: Yes
- 2: No
LABOUR FORCE STATUS (LMA2) - Question identifier:LMA2_Q06
What was the main reason that you were not available to work last week?
- 01: Own illness or disability
- 02: Caring for own children
- 03: Caring for an adult family member
- 04: Other personal or family responsibilities
- 05: Going to school
- 06: Vacation
- 07: Already have a job
- 08: Other Specify the main reason you were not available to work last week
CLASS OF WORKER (LMA3)
CLASS OF WORKER (LMA3) - Question identifier:LMA3_R01
Now some questions about the job or business at which you usually work the most hours.
CLASS OF WORKER (LMA3) - Question identifier:LMA3_Q01
Were you an employee or self-employed?
- 1: Employee
- 2: Self-employed
- 3: Working in a family business without pay
SELF-EMPLOYED (SEMP)
SELF-EMPLOYED (SEMP) - Question identifier:SEMP_Q05
What are the reasons you became self-employed?
- 01: Independence, flexibility or freedom
- 02: Due to nature of job
- 03: Wanted to have your own business or be your own boss
- 04: Family business or other business opportunity
- 05: Personal choice
- 06: Health condition
- 07: Higher income
- 08: Could not find work with employer or lack of job availability
- 09: Retirement
- 10: Personal or family responsibilities
- 11: Laid off or lost job
- 12: Other reason
JOB TENURE (JT)
JOB TENURE (JT) - Question identifier:JT_Q05
In which year did you start working for the employer you had last week?
Min = 1950; Max = 2022
JOB TENURE (JT) - Question identifier:JT_Q10
In which month did you start working for the employer you had last week?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 99: DK
JOB TENURE (JT) - Question identifier:JT_Q15
In which year did you start working at your current business?
Min = 1950; Max = 2022
JOB TENURE (JT) - Question identifier:JT_Q20
In which month did you start working at your current business?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 99: DK
INDUSTRY (LMA4)
INDUSTRY (LMA4) - Question identifier:LMA4_Q01
What was the full name of your business?
Long Answer Length = 50
INDUSTRY (LMA4) - Question identifier:LMA4_Q02
Last week, for whom did you work?
Long Answer Length = 50
INDUSTRY (LMA4) - Question identifier:LMA4_Q03
What kind of business, industry or service was this?
Long Answer Length = 50
OCCUPATION (LMA5)
OCCUPATION (LMA5) - Question identifier:LMA5_R01
The following questions refer to the work or occupation in which you spent most of your time.
OCCUPATION (LMA5) - Question identifier:LMA5_Q01
What kind of work were you doing?
Long Answer Length = 50
OCCUPATION (LMA5) - Question identifier:LMA5_Q02
What were your most important activities or duties?
Long Answer Length = 50
WORKPLACE (WKPL)
WORKPLACE (WKPL) - Question identifier:WKPL_Q05
In this job, are you a union member or covered by a union contract or collective agreement?
- 1: Yes
- 2: No
WORKPLACE (WKPL) - Question identifier:WKPL_Q10
About how many persons are employed at [your current business/the location where you now work]?
- 1: Less than 20
- 2: 20 to 99
- 3: 100 to 500
- 4: Over 500
- 9: DK
USUAL HOURS OF WORK (LMA6)
USUAL HOURS OF WORK (LMA6) - Question identifier:LMA6_Q01
[Excluding overtime, on average, how many paid hours do you usually work per week/On average, how many hours do you usually work per week]?
Min = 0.0; Max = 168.0
PART-TIME EMPLOYMENT (PT)
PART-TIME EMPLOYMENT (PT) - Question identifier:PT_Q05
What is the main reason you usually work less than 30 hours per week?
- 01: Temporary illness
- 02: Health condition
- 03: Caring for own children
- 04: Caring for an adult family member
- 05: Other personal or family responsibilities
- 06: Going to school
- 07: Economic conditions
- 08: Could not find work with 30 or more hours per week
- 09: Job is part-time or contract / More hours not available
- 10: Personal preference (e.g., do not want to work more than 30 hours)
- 11: Other reason Specify the reason for working less than 30 hours per week
PERMANENT WORK (PW)
PERMANENT WORK (PW) - Question identifier:PW_Q05
Is your job permanent, or is there some way that it is not permanent?
- 1: Permanent
- 2: Not permanent (e.g., seasonal, temporary, term, casual)
PERMANENT WORK (PW) - Question identifier:PW_Q10
In what way is your job not permanent?
- 1: Seasonal job
- 2: Temporary, term or contract job (e.g., non-seasonal)
- 3: Casual job
- 4: Work done through a temporary help agency
- 5: Student job
- 6: Apprenticeship, internship or articling position
- 7: Other reason Specify the reason why job is not permanent
PERIODS OF UNEMPLOYMENT (POU)
PERIODS OF UNEMPLOYMENT (POU) - Question identifier:POU_Q05
Have you had any periods of unemployment in the past five years?
- 1: Yes
- 2: No
PERIODS OF UNEMPLOYMENT (POU) - Question identifier:POU_Q10
How many different periods of unemployment did you have?
- 1: One
- 2: Two
- 3: Three or more
- 9: DK
EMPLOYMENT DETAILS (EDE)
EMPLOYMENT DETAILS (EDE) - Question identifier:EDE_Q05
Because of your condition, have you ever done any of the following?
- 1: Changed the kind of work you do
- 2: Changed the amount of work you do
- 3: Changed jobs
- 4: Began working from home
- 5: Taken an absence from work of one month or more
- 6: None of the above
EMPLOYMENT DETAILS (EDE) - Question identifier:EDE_Q10
Does your condition limit the amount or kind of work you can do at your present job or business?
- 1: Yes
- 2: No
EMPLOYMENT DETAILS (EDE) - Question identifier:EDE_Q15
Where were you employed when you first experienced work limitations?
- 1: Working with current employer or business
- 2: Working elsewhere
- 3: Not working
EMPLOYMENT DETAILS (EDE) - Question identifier:EDE_Q20
Are you now doing the same kind of work as you were doing at the time you first experienced work limitations?
- 1: Yes
- 2: No
EMPLOYMENT DETAILS (EDE) - Question identifier:EDE_Q25
Is your condition the reason you are now doing a different kind of work?
- 1: Yes
- 2: No
EMPLOYMENT DETAILS (EDE) - Question identifier:EDE_Q30
Do you believe that your condition makes it difficult for you to change jobs or to advance at your present job?
- 1: Yes, very difficult
- 2: Yes, difficult
- 3: No, not difficult
EMPLOYMENT DETAILS (EDE) - Question identifier:EDE_Q35
Why do you believe that your condition makes it difficult for you to change jobs or advance at your present job or business?
- 1: Discrimination or stigma because of condition
- 2: Condition limits number of hours that can be worked
- 3: Condition limits ability to search for a job
- 4: Difficult to obtain required supports or accommodations
- 5: Adapting to a new work environment would be difficult
- 6: Other reason
- 7: None of the above
EMPLOYMENT DETAILS (EDE) - Question identifier:EDE_Q40
Have you told your employer about your condition?
- 1: Yes
- 2: No
EMPLOYMENT DETAILS (EDE) - Question identifier:EDE_Q45
Considering your experience, education and training, how qualified do you feel for the job you held last week?
- 1: Overqualified
- 2: Qualified
- 3: Underqualified
- 9: DK
LOOKING FOR WORK (LW)
LOOKING FOR WORK (LW) - Question identifier:LW_Q05
What did you do to find work during the past four weeks?
- 01: Contacted employers directly
- 02: Looked at job ads
- 03: Placed or answered job ads
- 04: Contacted a government employment agency (e.g., Service Canada or a provincial/territorial employment centre)
- 05: Contacted a private employment agency
- 06: Contacted a union
- 07: Contacted friends or relatives
- 08: Other method to find work Specify the other method to find work
LOOKING FOR WORK (LW) - Question identifier:LW_Q10
As of last week, how many weeks have you been looking for work?
Min = 0; Max = 999
LOOKING FOR WORK (LW) - Question identifier:LW_Q15
In what kind of business, industry or service were you looking for work?
Long Answer Length = 80
LOOKING FOR WORK (LW) - Question identifier:LW_R20
Have any of the following caused you difficulty in finding work?
LOOKING FOR WORK (LW) - Question identifier:LW_Q20A
A. Not knowing how or where to look for work
- 1: Yes
- 2: No
LOOKING FOR WORK (LW) - Question identifier:LW_Q20B
B. Not knowing the type of job you wanted
- 1: Yes
- 2: No
LOOKING FOR WORK (LW) - Question identifier:LW_Q20C
C. Not having the work experience required for available jobs
- 1: Yes
- 2: No
LOOKING FOR WORK (LW) - Question identifier:LW_Q20D
D. Not having enough education or training for available jobs
- 1: Yes
- 2: No
LOOKING FOR WORK (LW) - Question identifier:LW_Q20E
E. Not having the means of transportation to get to available jobs
- 1: Yes
- 2: No
LOOKING FOR WORK (LW) - Question identifier:LW_Q20F
F. A shortage of jobs
- 1: Yes
- 2: No
LOOKING FOR WORK (LW) - Question identifier:LW_Q20G
G. Your age
- 1: Yes
- 2: No
LOOKING FOR WORK (LW) - Question identifier:LW_Q20H
H. Your health condition limits your search for work
- 1: Yes
- 2: No
LOOKING FOR WORK (LW) - Question identifier:LW_Q20I
I. Personal and family responsibilities
- 1: Yes
- 2: No
LOOKING FOR WORK (LW) - Question identifier:LW_Q20J
J. You experienced discrimination in the past
- 1: Yes
- 2: No
LOOKING FOR WORK (LW) - Question identifier:LW_Q20K
K. You experienced accessibility issues when applying for work
- 1: Yes
- 2: No
LOOKING FOR WORK (LW) - Question identifier:LW_Q25
You reported that you did not have the means of transportation to get to available jobs. Was this due to not having available accessible transportation?
- 1: Yes
- 2: No
PAST JOB ATTACHMENT (PJA)
PAST JOB ATTACHMENT (PJA) - Question identifier:PJA_Q05
Have you ever worked at a job or business?
- 1: Yes
- 2: No
PAST JOB ATTACHMENT (PJA) - Question identifier:PJA_Q10
When did you last work?
Min = 1922; Max = 2022
PAST JOB ATTACHMENT (PJA) - Question identifier:PJA_Q15
In which month did you last work?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 99: DK
CLASSIFICATION OF RETIREMENT (RETC)
CLASSIFICATION OF RETIREMENT (RETC) - Question identifier:RETC_Q05
At this time, do you consider yourself retired?
- 1: Yes
- 2: No
CLASSIFICATION OF RETIREMENT (RETC) - Question identifier:RETC_Q10
Would that be completely retired or partly retired?
- 1: Completely retired
- 2: Partly retired
CLASSIFICATION OF RETIREMENT (RETC) - Question identifier:RETC_Q15
Have you ever retired from a job or business?
- 1: Yes
- 2: No
CLASSIFICATION OF RETIREMENT (RETC) - Question identifier:RETC_Q20
After retirement, some people return to work and later retire again. Have you retired more than one time?
- 1: Yes
- 2: No
CLASSIFICATION OF RETIREMENT (RETC) - Question identifier:RETC_Q25
When did you [last/blank] retire?
Min = 1922; Max = 2022
RETIREMENT DETAILS (RDE)
RETIREMENT DETAILS (RDE) - Question identifier:RDE_Q05
Did you retire because of your condition?
- 1: Yes, completely
- 2: Yes, partially
- 3: No
RETIREMENT DETAILS (RDE) - Question identifier:RDE_Q10
In [year], did you retire from a job or business or did you stop looking for work?
- 1: Retired from job or business
- 2: Stopped looking for work
RETIREMENT DETAILS (RDE) - Question identifier:RDE_Q15
Was this retirement voluntary?
- 1: Yes
- 2: No
UNEMPLOYED DETAILS (UDE)
UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q05
When you last worked, how many hours did you usually work per week?
Min = 1; Max = 168
UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q10
Were you an employee or self-employed?
- 1: Employee
- 2: Self-employed
- 3: Working in a family business without pay
UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q15
What was the full name of your business?
Long Answer Length = 50
UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q20
For whom did you work?
Long Answer Length = 50
UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q25
What kind of business, industry or service was this?
Long Answer Length = 50
UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q30
What kind of work were you doing?
Long Answer Length = 50
UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q35
What were your most important activities or duties?
Long Answer Length = 50
UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q40
Does your condition limit the amount or kind of work you can do at a job or business?
- 1: Yes
- 2: No
UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q45
Were you working at a job or business at the time you became limited in the kind or amount of work you can do?
- 1: Yes
- 2: No
UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q50
Does your condition affect your ability to look for work?
- 1: Yes
- 2: No
UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q55
Because of your condition, are you limited in your ability to do any of the following?
- 1: Work at a full-time job
- 2: Work at a part-time job
- 3: Neither
UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q60
Did you tell your previous employer about your condition?
- 1: Yes
- 2: No
NOT IN THE LABOUR FORCE DETAILS (NDE)
NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q05
When you last worked, how many hours did you usually work per week?
Min = 1; Max = 168
NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q10
Were you an employee or self-employed?
- 1: Employee
- 2: Self-employed
- 3: Working in a family business without pay
NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q15
What was the full name of your business?
Long Answer Length = 50
NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q20
For whom did you work?
Long Answer Length = 50
NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q25
What kind of business, industry or service was this?
Long Answer Length = 50
NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q30
What kind of work were you doing?
Long Answer Length = 50
NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q35
What were your most important activities or duties?
Long Answer Length = 50
NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q40
Does your condition completely prevent you from working at a job or business?
- 1: Yes
- 2: No
NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q45
Is there some type of workplace arrangement or modification that would enable you to work at a paid job or business such as modified or different duties or technical aids?
- 1: Yes
- 2: No
NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q50
Does your condition limit the amount or kind of work you could do at a job or business?
- 1: Yes
- 2: No
NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q55
Were you working at a job or business at the time you became [completely unable to work/limited in the amount or kind of work you could do]?
- 1: Yes
- 2: No
NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q60
Does your condition affect your ability to look for work?
- 1: Yes
- 2: No
NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q65
Have you looked for work in the past two years?
- 1: Yes
- 2: No
NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q70
Some people have encountered barriers which have discouraged them from looking for work. Thinking about your own experience, indicate which of the following situations might apply to you.
- 01: Your expected employment income would be less than your current income
- 02: You would lose additional supports (e.g., drug plan or housing)
- 03: Lack of specialized transportation
- 04: Family responsibilities prevent you from working
- 05: Past attempts to find work have been unsuccessful
- 06: Family or friends discourage you from working
- 07: You have experienced discrimination in the past
- 08: You feel your training or experience is not adequate for the current job market
- 09: Few jobs available in the local area
- 10: You experienced accessibility issues when applying for work
- 11: Health condition
- 12: Age
- 13: Other barrier Specify the other barrier
- 14: None
NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q75
Did you tell your previous employer about your condition?
- 1: Yes
- 2: No
- 9: DK
LABOUR MARKET ATTACHMENT (LA)
LABOUR MARKET ATTACHMENT (LA) - Question identifier:LA_Q05
Did you want a job last week?
- 1: Yes
- 2: No
LABOUR MARKET ATTACHMENT (LA) - Question identifier:LA_Q10
What was the main reason you did not look for work last week?
- 01: Temporary illness
- 02: Health condition
- 03: Caring for own children
- 04: Caring for an adult family member
- 05: Other personal or family responsibilities
- 06: Going to school
- 07: Waiting for recall to former job
- 08: Waiting for replies from employers
- 09: Believed no work is available in the area
- 10: Believed no work is available suited to skills
- 11: Fear of prejudice or discrimination
- 12: No reason
- 13: Other reason for not looking for work
LABOUR MARKET ATTACHMENT (LA) - Question identifier:LA_Q15
Could you have worked last week if a suitable job had been offered?
- 1: Yes
- 2: No
LABOUR MARKET ATTACHMENT (LA) - Question identifier:LA_Q20
What was the main reason you were not available to work last week?
- 01: Temporary illness
- 02: Health condition
- 03: Caring for own children
- 04: Caring for an adult family member
- 05: Other personal or family responsibilities
- 06: Going to school
- 07: Vacation
- 08: Already have a job
- 09: Other reason Specify main reason for not being available for work last week
LABOUR MARKET ATTACHMENT (LA) - Question identifier:LA_Q25
Do you think that you will look for work any time in the next 12 months?
- 1: Yes
- 2: No
LABOUR MARKET ATTACHMENT (LA) - Question identifier:LA_Q30
Why do you think that you will look for work any time in the next 12 months?
- 1: You expect your condition to improve
- 2: There will be changes or improvements in the workplace
- 3: You will be taking training
- 4: Will be graduating from school
- 5: Another reason
- 6: No reason
PERIODS OF EMPLOYMENT (POE)
PERIODS OF EMPLOYMENT (POE) - Question identifier:POE_Q05
Have you had any periods of employment in the last 12 months; that is to say, periods when you had a job or business?
- 1: Yes
- 2: No
PERIODS OF EMPLOYMENT (POE) - Question identifier:POE_Q10
How many different periods of employment did you have?
- 1: One
- 2: Two
- 3: Three or more
PERIODS OF EMPLOYMENT (POE) - Question identifier:POE_Q15
What was the length of the longest period of employment?
- 1: Under three months
- 2: Three to five months
- 3: Six months or more
WORKPLACE TRAINING (WTR)
WORKPLACE TRAINING (WTR) - Question identifier:WTR_R05
The next few questions deal with job-related training paid for or provided by your employer or company.
WORKPLACE TRAINING (WTR) - Question identifier:WTR_Q05
In the past 12 months, have you received any classroom training related to your job?
- 1: Yes
- 2: No
WORKPLACE TRAINING (WTR) - Question identifier:WTR_Q10
During the last 12 months of your previous employment, did you receive any classroom training related to your job?
- 1: Yes
- 2: No
WORKPLACE TRAINING (WTR) - Question identifier:WTR_Q15
In the past 12 months, have you received any on-the-job training?
- 1: Yes
- 2: No
WORKPLACE TRAINING (WTR) - Question identifier:WTR_Q20
During the last 12 months of your previous employment, did you receive any on-the-job training?
- 1: Yes
- 2: No
WORKPLACE TRAINING (WTR) - Question identifier:WTR_Q25
In the past 12 months, did you participate in any work-related training that was not paid for or provided by an employer?
- 1: Yes
- 2: No
WORKPLACE TRAINING (WTR) - Question identifier:WTR_Q30
Who paid for this training?
- 1: Paid for it yourself
- 2: Provided by government program
- 3: Provided by non-profit organization or other agency for free
- 4: Other
- 9: DK
WORKPLACE TRAINING (WTR) - Question identifier:WTR_Q35
In the past 12 months, did you want to take some work-related training courses?
- 1: Yes
- 2: No
- 9: DK
WORKPLACE TRAINING (WTR) - Question identifier:WTR_Q40
Did any of the following prevent you from taking any work-related training courses?
- 01: Location was not physically accessible
- 02: Courses were not adapted to the needs of your condition
- 03: You requested courses but were denied them by employer
- 04: Your condition
- 05: Inadequate transportation
- 06: Too costly
- 07: Too busy
- 08: Other reason
- 99: DK
WORKPLACE TRAINING (WTR) - Question identifier:WTR_Q45
Why did you not want to take any work-related training courses?
- 01: Location was not physically accessible
- 02: Courses were not adapted to the needs of your condition
- 03: You requested courses but were denied them by employer
- 04: Your condition
- 05: Inadequate transportation
- 06: Too costly
- 07: Too busy
- 08: Other reason
- 09: No reason
EMPLOYMENT MODIFICATIONS (EMO)
EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q05
Because of your condition, [do/would] you require any of the following to be able to work?
- 01: Modified or different duties
- 02: Working from home
- 03: Modified hours or days or reduced work hours
- 04: Human support (e.g., reader, sign language interpreter, job coach or personal assistant)
- 05: Technical aids (e.g., voice synthesizer, TTY, infrared system or portable note-taker)
- 06: Computer, laptop or tablet with specialized software or other adaptations (e.g., braille, screen magnification software, voice recognition software or a screen reader)
- 07: Communication aids (e.g., braille or large print reading material or recording equipment)
- 08: Modified or ergonomic workstation
- 09: Special chair or back support
- 10: Handrails, ramps, widened doorways or hallways
- 11: Adapted or accessible parking
- 12: Accessible elevators
- 13: Adapted washrooms
- 14: Specialized transportation
- 15: Other equipment, help or work arrangement Specify the other equipment, help or work arrangement
- 16: None of the above
EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q10
Which of the following have been made available to you?
- 01: Modified or different duties
- 02: Working from home
- 03: Modified hours or days or reduced work hours
- 04: Human support (e.g., reader, sign language interpreter, job coach or personal assistant)
- 05: Technical aids (e.g., voice synthesizer, TTY, infrared system or portable note-taker)
- 06: Computer, laptop or tablet with specialized software or other adaptations (e.g., braille, screen magnification software, voice recognition software or screen reader)
- 07: Communication aids (e.g., braille or large print reading material or recording equipment)
- 08: Modified or ergonomic workstation
- 09: Special chair or back support
- 10: Handrails, ramps, widened doorways or hallways
- 11: Adapted or accessible parking
- 12: Accessible elevators
- 13: Adapted washrooms
- 14: Specialized transportation
- 15: [EMO_Q05 Category 15 response/Other equipment, help or work arrangement]
- 16: None of the above
EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q15
Did you ask your employer for the workplace accommodations that have not been made available to you?
- 1: Yes
- 2: No
EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q20
Why have you not received the workplace accommodations that you need?
- 1: Too expensive (e.g., purchase, maintenance or repair)
- 2: Employer or supervisor refused request
- 3: On a waiting list
- 4: Not available locally
- 5: Other reason Specify the other reason you have not received workplace accommodations
EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q25
Is your employer aware that you need the workplace accommodations?
- 1: Yes
- 2: No
- 9: DK
EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q30
Why have you not asked for the workplace accommodations needed?
- 01: Uncomfortable asking
- 02: Did not want to cause difficulty for employer
- 03: Did not think employer could afford or find proper accommodations
- 04: Did not want to disclose the need for accommodation
- 05: Concerned about reaction of co-workers
- 06: Fear of negative outcomes
- 07: Condition is not severe enough
- 08: Lack of awareness or understanding by employer with respect to accommodation requests
- 09: Been refused in the past
- 10: Other reason Specify the other reason you have not asked for workplace accommodations
EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q35
Did you ask your previous employer for the workplace accommodations that have not been made available?
- 1: Yes
- 2: No
EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q40
Why did you not receive the workplace accommodations needed?
- 1: Too expensive (e.g., purchase, maintenance or repair)
- 2: Employer or supervisor refused request
- 3: On a waiting list
- 4: Not available locally
- 5: Other reason Specify the other reason you did not receive workplace accommodations
EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q45
Was your previous employer aware that you needed the workplace accommodations?
- 1: Yes
- 2: No
- 9: DK
EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q50
Why did you not ask for the workplace accommodations needed?
- 01: Uncomfortable asking
- 02: Did not want to cause difficulty for employer
- 03: Did not think employer could afford or find proper accommodations
- 04: Did not want to disclose the need for accommodation
- 05: Concerned about reaction of co-workers
- 06: Fear of negative outcomes
- 07: Condition is not severe enough
- 08: Lack of awareness or understanding by employer with respect to accommodation requests
- 09: Been refused in the past
- 10: Other reason Specify the other reason you did not ask for workplace accommodations
LABOUR FORCE DISCRIMINATION (LFD)
LABOUR FORCE DISCRIMINATION (LFD) - Question identifier:LFD_Q05
In the past five years, do you believe that because of your condition, you have been refused a job interview?
- 1: Yes
- 2: No
LABOUR FORCE DISCRIMINATION (LFD) - Question identifier:LFD_Q10
In the past five years, do you believe that because of your condition, you have been refused a job?
- 1: Yes
- 2: No
LABOUR FORCE DISCRIMINATION (LFD) - Question identifier:LFD_Q15
In the past five years, do you believe that because of your condition, you have been refused a job promotion?
- 1: Yes
- 2: No
LABOUR FORCE DISCRIMINATION (LFD) - Question identifier:LFD_Q20
Do you consider yourself to be disadvantaged in employment because of your condition?
- 1: Yes
- 2: No
LABOUR FORCE DISCRIMINATION (LFD) - Question identifier:LFD_Q25
Do you believe that your current employer or any potential employer would be likely to consider you disadvantaged in employment because of your condition?
- 1: Yes
- 2: No
VETERANS (VAC)
VETERANS (VAC) - Question identifier:VAC_Q05
Have you ever served in the Canadian military?
- 1: Yes
- 2: No
VETERANS (VAC) - Question identifier:VAC_Q10
Are you currently a member of the Canadian Armed Forces?
- 1: Yes
- 2: No
VETERANS (VAC) - Question identifier:VAC_Q15
In what year did you release from the Canadian Armed Forces?
Min = 1914; Max = 2022
INTERNET USE (IU)
INTERNET USE (IU) - Question identifier:IU_R05
Now some questions about the use of the Internet.
INTERNET USE (IU) - Question identifier:IU_Q05
During the past 12 months, have you used the Internet for personal use, from any location?
- 1: Yes
- 2: No
INTERNET USE (IU) - Question identifier:IU_Q10
Why have you not used the Internet during the past 12 months for personal use?
- 01: Cost of service or equipment
- 02: No need, no interest or no time
- 03: Too difficult to use the Internet (e.g., lack of confidence, knowledge, skills or training)
- 04: Limited due to health condition
- 05: Confidentiality, security or privacy concerns
- 06: Limited or no access to Internet
- 07: No Internet-ready device available in dwelling (e.g., desktop, laptop or tablet computer)
- 08: Require specialized adaptations or software
- 09: Too many websites are inaccessible
- 10: Other reason
INTERNET USE (IU) - Question identifier:IU_Q15
During the past 12 months, what activities did you perform on the Internet to interact with any level of government?
- 01: Filed your income taxes on your own (i.e., not submitted by someone else)
- 02: Paid a government service fee, tax, fine or ticket (e.g., driver's licence renewal, parking ticket)
- 03: Researched information (e.g., bylaws, regulations, programs or services)
- 04: Expressed your opinion or provided feedback during an online government consultation relating to government policies or programs
- 05: Downloaded a government form that was submitted in person (e.g., passport renewal application, Old Age Security application, driver's licence renewal, building permit)
- 06: Submitted a form or application for a government program or service online
- 07: Accessed an account for a government program or service (e.g., My Account, accounts associated with driver's licences or health cards, public library account)
- 08: Communicated with a government organization by email or via social networking
- 09: Other activities
- 10: None
INTERNET USE (IU) - Question identifier:IU_Q20
During the past 12 months, when using the Internet to interact with government officials, websites or services in Canada, did you encounter any of the following problems?
- 01: Difficult to find the correct website
- 02: Difficult to find the information you needed on the website
- 03: The website was experiencing technical difficulties
- 04: The information provided on the website was missing or out-dated
- 05: The website's functions were not compatible with your Internet-connected device
- 06: You had concerns for your security or privacy
- 07: Accessibility issues related to your condition
- 08: Other problems
- 09: Did not encounter any problems
INTERNET USE (IU) - Question identifier:IU_Q25
What are the reasons you have not used the Internet to interact with government officials, websites or services in Canada during the past 12 months?
- 01: No need, not interested or no time
- 02: Too difficult to find the correct website or information on the website
- 03: Easier to contact the government in person or by telephone
- 04: Concern for security or privacy
- 05: Never thought of searching or communicating that way
- 06: Accessibility issues related to your condition
- 07: Other reason Specify the other reason you have not used the Internet to interact with government officials, websites or services
- 08: None of the above
INTERNET USE (IU) - Question identifier:IU_Q30
During the past three months, what other activities have you done over the Internet?
- 01: Communicated with others (e.g., emails, social networking, video calls, dating sites, sharing sites, blogs, meetings, family events, etc.)
- 02: Accessed information (e.g., news, directions, researched information on health, products, services or community events, etc.)
- 03: Searched for employment
- 04: Conducted online banking
- 05: Attended regular school classes (e.g., high school, university or other post-secondary classes, etc.)
- 06: Took training courses or workshops
- 07: Made a donation to a charity
- 08: Booked appointments
- 09: Purchased goods or services
- 10: Sold goods or services
- 11: Tracked fitness or health
- 12: Other online activities
- 13: None of these activities
ACCESSIBILITY BARRIERS (BAR)
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_R05A
We now want you to think about accessibility barriers that might limit your access to different areas and activities in your daily life due to your condition. By barriers we mean something that could be removed, modified, or done differently.
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_R05B
In the past 12 months, have you experienced barriers with any of the following features inside or outside public spaces because of your condition(s)?
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q05A
A. Entrances or exits to buildings
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q05B
B. Floorplans inside buildings
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q05C
C. Lighting or sound levels inside buildings
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q05D
D. Public washrooms
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q05E
E. Wait lines
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q05F
F. Self-serve technology
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q05G
G. Announcements or alarms
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q05H
H. Signs or directions
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q05I
I. Pedestrian signals at intersections or crosswalks
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q05J
J. Sidewalks when covered in ice or snow
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q05K
K. Sidewalks in general
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_R10
In the past 12 months, have you experienced any barriers in terms of behaviours, misconceptions or assumptions made about you from any of the following because of your condition(s)?
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q10A
A. Family or close friends
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q10B
B. Staff of a business
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q10C
C. Medical or health care professionals
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q10D
D. Staff of government services or programs
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_R15
In the past 12 months, have you experienced barriers communicating in any of the following situations because of your condition(s)?
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q15A
A. In person with family or close friends
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q15B
B. In person with medical or health care professionals
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q15C
C. In person with others such as the general public, customer service or government representatives
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q15D
D. By voice over the phone with family or close friends
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q15E
E. By voice over the phone with medical or health care professionals
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q15F
F. By voice over the phone with others such as the general public, customer service or government representatives
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q15G
G. With an automated phone message system
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q15H
H. Using video conferencing
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q15I
I. Using social media or online chat forums to interact with others
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_R20
In the past 12 months, have you experienced barriers using the Internet for any of the following activities because of your condition(s)?
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q20A
A. Online banking or online shopping
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q20B
B. Online booking for appointments, services or reservations
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
ACCESSIBILITY BARRIERS (BAR) - Question identifier:BAR_Q20C
C. Online access to government information, services or supports
- 1: Not applicable
- 2: Never
- 3: Sometimes
- 4: Often
- 5: Always
GENERAL HEALTH (GH)
GENERAL HEALTH (GH) - Question identifier:GH_R05
Now, some questions about your health. By health, we mean not only the absence of disease or injury but also physical, mental and social well-being.
GENERAL HEALTH (GH) - Question identifier:GH_Q05
In general, how is your health?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
GENERAL HEALTH (GH) - Question identifier:GH_Q10
In general, how is your mental health?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
HOUSEBOUND (HB)
HOUSEBOUND (HB) - Question identifier:HB_Q05
Do you consider yourself housebound due to your condition?
- 1: No
- 2: Rarely
- 3: Sometimes
- 4: Often
- 5: Always
HOUSEBOUND (HB) - Question identifier:HB_Q10
What are the reasons you [rarely/sometimes/often/always] consider yourself housebound?
- 01: You do not feel safe when you leave your home
- 02: Your condition or health problem fluctuates
- 03: Your condition or health problem is aggravated when you go out
- 04: You have mobility restrictions
- 05: Your social connections outside the home are limited
- 06: No motivation, lack desire or not interested
- 07: Financial reasons
- 08: No attendant or companion is available to help you
- 09: Accessible transportation is not available to you or is unreliable
- 10: The places you want to go are not accessible to you
- 11: Weather conditions or seasonal limitations
- 12: Other reason Specify the other reason you consider yourself housebound
SOCIAL ISOLATION (SI)
SOCIAL ISOLATION (SI) - Question identifier:SI_R05
The next questions are about how you feel about different aspects of your life.
SOCIAL ISOLATION (SI) - Question identifier:SI_Q05
How often do you feel that you lack companionship?
- 1: Hardly ever
- 2: Some of the time
- 3: Often
- 9: DK
SOCIAL ISOLATION (SI) - Question identifier:SI_Q10
How often do you feel left out?
- 1: Hardly ever
- 2: Some of the time
- 3: Often
- 9: DK
SOCIAL ISOLATION (SI) - Question identifier:SI_Q15
How often do you feel isolated from others?
- 1: Hardly ever
- 2: Some of the time
- 3: Often
- 9: DK
SOCIAL ISOLATION (SI) - Question identifier:SI_Q20
Do you have any relatives or friends who you feel close to, that is, who you feel at ease with, can talk to about what is on your mind, or call on for help?
- 1: Yes
- 2: No
SOURCES OF INCOME (SNC)
SOURCES OF INCOME (SNC) - Question identifier:SNC_R05A
Now a question about personal income sources.
SOURCES OF INCOME (SNC) - Question identifier:SNC_Q05A
Did you receive income from any of the following sources for the year ending December 31, 2021?
- 01: Employment (Include wages, salaries, commissions and tips.)
- 02: Self-employment (Include wages, salaries, commissions and tips.)
- 03: Workers' Compensation
- 04: Employment Insurance or Quebec Parental Insurance Plan (Exclude Short-term disability sickness benefit.)
- 05: Pension plan benefits (Exclude disability benefits.)
- 06: Social assistance or welfare (Exclude disability benefits or income from provincial or territorial programs such as ODSP, DSP, AISH, PPMB, etc.)
- 07: Disability Benefits (Include income from federal, provincial or territorial programs such as Disability benefits from Canada Pension Plan, Quebec Pension Plan or Veterans Affairs, ODSP, DSP, AISH, PPMB, etc. as well as private benefits or programs.)
- 08: Federal or provincial COVID-19 emergency benefits
- 09: Other sources (e.g., other government income, child tax benefit, child support, education allowances and scholarships, Northern Allowance, spousal support, honoraria)
- 10: No personal income source
SOURCES OF INCOME (SNC) - Question identifier:SNC_Q05B
Which of the following pension plan benefits did you receive?
- 1: Canada Pension Plan (CPP)
- 2: Quebec Pension Plan (QPP)
- 3: Old Age Security (OAS) or Guaranteed Income Supplement (GIS)
- 4: Provincial or Territorial pension plan
- 5: Private or employment related pension plan
- 6: Other retirement pensions and annuities
SOURCES OF INCOME (SNC) - Question identifier:SNC_Q05C
Which of the following disability plan benefits did you receive?
- 01: Canada Pension Plan Disability (CPP-D) benefits
- 02: Quebec Pension Plan Disability benefits
- 03: Employment Insurance short-term disability sickness benefit (Include Quebec Parental Insurance (QPIP) disability benefits)
- 04: Provincial or territorial disability programs (e.g., ODSP, DSP, AISH, PPMB)
- 05: Private or employment related disability insurance plan
- 06: Motor vehicle accident insurance disability
- 07: Veterans Affairs Disability benefits
- 08: Registered Disability Savings Plan (RDSP)
- 09: Other disability plan benefits
FOOD SECURITY (FS)
FOOD SECURITY (FS) - Question identifier:FS_R05
The following statements may describe the food situation for your household in the past 12 months. Please indicate if the statement was often true, sometimes true or never true for [you/you and other household members] in the past 12 months.
FOOD SECURITY (FS) - Question identifier:FS_Q05A
A. The food that [you/you and other household members] bought just didn't last, and there wasn't any money to get more
- 1: Often true
- 2: Sometimes true
- 3: Never true
FOOD SECURITY (FS) - Question identifier:FS_Q05B
B. [You/You and other household members] couldn't afford to eat balanced meals
- 1: Often true
- 2: Sometimes true
- 3: Never true
FOOD SECURITY (FS) - Question identifier:FS_Q10
In the past 12 months, since last ^CurrentMonth, did [you/you or other adults in your household] ever cut the size of your meals or skip meals because there wasn't enough money for food?
- 1: Yes
- 2: No
FOOD SECURITY (FS) - Question identifier:FS_Q15
How often did this happen?
- 1: Almost every month
- 2: Some months but not every month
- 3: Only 1 or 2 months
FOOD SECURITY (FS) - Question identifier:FS_Q20
In the past 12 months, did you personally ever eat less than you felt you should because there wasn't enough money to buy food?
- 1: Yes
- 2: No
FOOD SECURITY (FS) - Question identifier:FS_Q25
In the past 12 months, were you personally ever hungry but didn't eat because you couldn't afford enough food?
- 1: Yes
- 2: No
HOMELESSNESS (HOM)
HOMELESSNESS (HOM) - Question identifier:HOM_R05
The following question is about homelessness.
HOMELESSNESS (HOM) - Question identifier:HOM_Q05
Have you ever experienced homelessness where you have been without a secure and stable place to live?
- 1: Yes
- 2: No
COVID-19 (COV)
COVID-19 (COV) - Question identifier:COV_R05
Now some questions about the COVID-19 pandemic.
COVID-19 (COV) - Question identifier:COV_Q05
Which of the following best describes the impact of the COVID-19 pandemic on your ability to meet financial obligations such as rent or mortgage payments, utilities and groceries?
- 1: Major impact
- 2: Moderate impact
- 3: Minor impact
- 4: No impact
- 5: Too soon to tell
COVID-19 (COV) - Question identifier:COV_Q10
During the COVID-19 pandemic, did you lose your job, become laid off or have reduced work hours?
- 1: Yes
- 2: No
- 3: Not applicable
COVID-19 (COV) - Question identifier:COV_Q15
Have you ever tested positive for COVID-19?
- 1: Yes
- 2: No
COVID-19 (COV) - Question identifier:COV_Q20
Have you ever been vaccinated against COVID-19?
- 1: Yes
- 2: No
SEXUAL ORIENTATION (SOR)
SEXUAL ORIENTATION (SOR) - Question identifier:SOR_Q01
What is your sexual orientation?
- 1: Heterosexual
- 2: Lesbian or gay
- 3: Bisexual
- 4: Or please specify Specify your sexual orientation
SELF-IDENTIFICATION (DIS)
SELF-IDENTIFICATION (DIS) - Question identifier:DIS_Q05
Do you identify as a person with a disability?
- 1: Yes
- 2: No
FUTURE SURVEYS (SUR)
FUTURE SURVEYS (SUR) - Question identifier:SUR_R05
Statistics Canada is planning a series of short, 15-20 minute surveys about important social topics. These surveys will be sent out in the near future and will ask about a wide variety of issues that affect Canadian society. By participating in this survey series, you will be able to share your opinions and thoughts on these issues and compare your ideas with those of other Canadians.
FUTURE SURVEYS (SUR) - Question identifier:SUR_Q05
Would you like to sign-up for future surveys?
- 1: Yes
- 2: No (Note: Your household will remain eligible for other Statistics Canada surveys.)
FUTURE SURVEYS (SUR) - Question identifier:SUR_R10
Please provide the following information so we can email or text you to participate in this survey series.
FUTURE SURVEYS (SUR) - Question identifier:SUR_Q10A
Email address
Long Answer Length = 80
FUTURE SURVEYS (SUR) - Question identifier:SUR_Q10B
Cellular number
Long Answer Length = 12
FUTURE SURVEYS (SUR) - Question identifier:SUR_R15
Thank you for signing up. We will contact you soon
- Date modified: