Questionnaire Text

Dec 2022
Dec 2021
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Dec 2022
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SSM3
Did this ever happen in the last 30 days?
(1) Yes
(2) No
Blind (D) or (R)

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Dec 2021
Questionnaire form view entire document:  text  image
SSM3
Did this ever happen in the last 30 days?
(1) Yes
(2) No
Blind (D) or (R)