Attachment 3f
Mobile Exam Center (MEC) Interview
Hand Cards
2021-22
 
	SXQ1 
Lesbian or gay
Straight, that is, not lesbian or gay
Bisexual
Something else
I don’t know the answer
 
	SXQ2 
Gay
Straight, that is, not gay
Bisexual
Something else
I don’t know the answer
	DPQ1 
Not at all
Several days
More than half the days
Nearly every day
| Pregnancy | 
			 
 
 | |
| Breastfeeding | 
			 | |
| Total or Partial Hysterectomy (Surgery to Remove Uterus/Womb) | 
			 | |
| Menopause / Change of Life | 
			 
				Night
				sweats 
				Hot
				flashes 
				Loss
				of libido 
				Sleep
				issues 
				 
				symptoms 
				Mood
				swings 
				Vaginal
				dryness | |
| Other Reasons | 
			 
				Medical conditions, like cancer Medical
				treatments, like chemotherapy Birth control
								 Excessive
				exercise Low body
				weight Something
				else? | 
| 
			 
 
 12 ounces of beer | 
			 
 
 | 
| 
			 | 
			 | 
| 
			 
 5 ounces of wine | 
			 | 
| 
			 | 
			 | 
| 
			 1.5 ounces of hard liquor | 
			 | 
	
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| Author | Frenk, Steven M. (CDC/OPHSS/NCHS) | 
| File Modified | 0000-00-00 | 
| File Created | 2021-01-22 |