Page 169 - QAP Manual 2020

NCI™ ADULT IN-PERSON SURVEY (IPS) 2020-21

BI-5 Does this person have a legal appointed guardian/conservator (a person who is legally
granted authority to make decisions on behalf of the individual)? Check ONE.

□ 1. No, person does not have a guardian/conservator (legally competent or presumed
competent) →Code BI-6 as ‘Not applicable’
□ 2. Yes, limited guardianship (a person has authority over certain decisions, such as entering
into contracts, medical procedures, etc.)
□ 3. Yes, full guardianship

□ 4. Yes, unable to distinguish between limited or full guardianship
□ 99. Don’t know →Skip BI-6 and go to BI-7

BI-6 If this person has a legal/court-appointed guardian, what is the guardian’s relationship to the
individual? Check ONE.
□ 98. Not applicable
□ 1. Family

□ 2. Friend
□ 3. Public guardian/Public administrator
□ 4. Financial institution (e.g., bank)
□ 5. Non-profit guardianship agency

□ 6. For-profit guardianship agency
□ 7. Other: ____________________________________________
□ 99. Don’t know

BI-7 Marital status. Check ONE.

□ 1. Single, never married
□ 2. Married
□ 3. Single, married in the past
□ 99. Don’t know

BI-8 Is this person a parent? (This includes adult children.) Check all that apply.

1. No, does not have a child →Code BI-9 as ‘Not applicable’
2. Yes, parent of a child or children under 18
3. Yes, parent of a child or children over 18
99. Don’t know →Skip BI-9 and go to BI-10

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