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a~- <br />10, HOW MANY FULL TIMT;/P1;RMANT;NT <br />RT;SH));NTS LIVl; IN THIS HOUSEHOLD? <br />i 1. WHAT YEAR WAS THT; HOUSlJ BUILT? <br />12. DO1;S THTJ HOMI; HAV1; ITS OWN W1rLL? <br />13. HOW LONG HAS YOUR FAMILY LIVID AT THIS <br />ADDRISS? <br />14. WHIRL DID YOU LIVI BIFORI THIS HOUSI? <br />^ YES <br />YYYY <br />^ NO <br />Previous Address <br />Address <br />Previous <br />Address <br />Previous Address <br />COMMENTS: <br />Cancer History <br />15. HAVI YOU OR ANYONI IN YOUR HOUSIHOLD <br />IVIR BIIN DIAGNOSID WITH CANCIR? <br />Number of Years <br />Number of Years <br />Number of Years <br />Number of Years <br />Number of Years <br />^ YES ^ NO <br />16. WHAT'S YOUR RILATIONSHIl' TO PIRSON WHO WAS DIAGNOSID WITH CANCER? <br />^ SILF ^ SIBLING <br />^ SPOUSI ^ OTHIR: <br />^ CHILD ^ NO RELATION <br />^ PARENT <br />17. IS YOUR «pIRSON» OVIR 18 YIARS OF AGI? ^ YES ^ NO <br />18. IS YOUR «PIRSON» AVAILABLI FOR AN ^ YES ^ NO <br />INTIRVIIW? <br />19. IS YOUR «PIRSON» DICIASID? ^ YES ^ NO <br />Page 22 of 47 <br />