HEADLA@*

SHOW CARD C12

Because of a health problem, [^do you / does he / does she] have difficulty doing any of the

activities on this card? Exclude any difficulties that you expect to last less than three months

INTERVIEWER: PROBE - 'What others?'····Code all that apply.

01 Walking 100 yards

02 Sitting for about two hours

03 Getting up from a chair after sitting for long periods

04 Climbing several flights of stairs without resting

05 Climbing one flight of stairs without resting

06 Stooping, kneeling, or crouching

07 Reaching or extending [^your / his / her] arms above shoulder level (either arm)

08 Pulling or pushing large objects like a living room chair