Page 186 - QAP Manual 2020
P. 186

NCI™ ADULT IN-PERSON SURVEY (IPS) 2020-21
 □  1. No   Number of   N/A     N/A               N/A
 BI-48 Unpaid activity in a facility-based
 setting   □  2. Yes   hours spent at
 □  99. Don’t   activity in
 (e.g., day habilitation, seniors programs,   know   typical two-
 drop-in centers)   week period:
 __ __ __
 If the person does more than one activity of
 this type, please refer to the activity at which
 the person has spent the most time in the
 past two weeks.











































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