Did you ever serve in a combat or war zone?

Has a doctor or other health professional ever told you that you have depression, anxiety, or post traumatic stress disorder (PTSD)?

A traumatic brain injury may result from a violent blow to the head or when an object pierces the skull and enters the brain tissue. Has a doctor or other health professional ever told you that you have suffered a traumatic brain injury (TBI)?

In the past 12 months, did you receive any psychological or psychiatric counseling or treatment?

Has there been a time in the past 12 months when you thought of taking your own life?

During the past 12 months, did you attempt to commit suicide?

Which of the following best describes your service in the United States military?

In the last 12 months, have you received some or all of your health care from VA hospital or clinic?

Since September 11, 2001, have you been deployed to the regions of Afghanistan or Iraq in support of U.S. military operations?

INTERVIEWER NOTE: This includes countries in the Middle East region such as Iraq, Saudi Arabia, Kuwait, the Persian Gulf, and other forward deployed operating areas such as the countries bordering Afghanistan.

In the last 12 months have you received some or all of your health care from VA facilities?

Have you ever served on active duty in the United States Armed Forces, either in the regular military or in a National Guard or military reserve unit? Active duty does not include training for the Reserves or National Guard, but DOES include activation, for example, for the Persian Gulf War.

The next question relates to military service in the United States Armed Forces, either in the regular military or in a National Guard or Reserve unit.

Have you ever served on active duty in the United States Armed Forces, either in the regular military or in a National Guard or military reserve unit?

Which of the following best describes your service in the United States military?

During the past year have you known or seen anyone who was beaten or otherwise hurt by their husband, wife, boyfriend, or girlfriend?

How afraid are you to leave your home at night? Would you say:

• Very afraid
• Somewhat afraid
• A little afraid
• Not afraid

When was the last time you saw a violent crime in your neighborhood (someone hurting or trying to hurt someone else)?

Has a doctor, nurse or other health professional ever said that you have vision impairment in one of both eyes, even when wearing glasses?

Now I would like to ask you questions about your vision. These questions are for all respondents regardless of whether or not you wear glasses or contact lenses. If you wear glasses or contact lenses, answer questions as if you are wearing them.

How much difficulty, if any, do you have in recognizing a friend across the street?

How much difficulty, if any, do you have reading print in newspapers, magazines, recipes, menus, or numbers on the telephone?

When was the last time you had your eyes examined by any doctor or eye care provider?

What is the main reason you have not visited an eye care professional in the past 12 months?

When was the last time you had an eye exam in which the pupils were dilated? This would have made you temporarily sensitive to bright light.

Do you have any kind of health insurance coverage for eye care?

Have you been told by an eye doctor or other health care professional that you NOW have cataracts?

Have you EVER been told by an eye doctor or other health care professional that you had glaucoma?

Age-related Macular Degeneration (AMD) is a disease that affects the macula, the part of the eye that allows you to see fine detail.

Have you EVER been told by an eye doctor or other health care professional that you had age-related macular degeneration?