Satisfaction with current health status
Happy with personal life last month
Concerned about your health
Full of interesting things
Cholesterol level checked in past five years
Blood pressure checked in past two years
Blood pressure normal
Smoke or use tobacco now
Typo of tobacco used
Frequency of smoking(amt/day)
Days smoked during the past 30 days
Cigarettes smoked last month
Past 2 weeks: how many times 5 + drinks
Number of drinks others have at parties
Ever injure self because of drinking
Ever injure anyone else because of your drinking
Rode in a car driven by someone who had been drinking
Drove after having three or more drinks
Ever tried marijuana
Past month, times used marijuana
Ever tried cocaine or crack
Past month, times used cocaine or crack
Ever tried hallucinogens
Past month, times used hallucinogens
Ever tried amphetamines
Past month, times used amphetamines
Ever tried ritalin
Past month, times used ritalin
Ever tried heroin, opium, or other narcotics
Past month, times used narcotics
Ever regularly smoked cigarettes or used tobacco
Past year, sought counseling for stress
Handling the stress
Sex
Marital status
Ever engaged in sexual intercourse
Age first engaged in sexual intercourse
Number of sexual partners last year
Last sexual intercourse, contraceptive used
Used birth control pills
Intrauterine device(IUD)
Diaphragm
Foam or other spermicide
Condoms
Withdrawal
Rhythm Method
Norplant
Sterilization
Morning after pill, plan B, emergency contraception
Cervical Cap
Depo-Provera
Lunelle
Other
Refused
Don't know
No answer
Ever had sexually transmitted disease
Chlamydia
Genital/veneral warts/condyloma/HPV
Gonorrhea
Herpes, HSV
Trichomonas
HIV/AIDS
Ever been/gotten someone pregnant
Pregnancies intended or accidental
Pregnancies while student at the UO
Past year, forced to have sexual intercourse
Sexual orientation
Had a Pap smear test in the past 3 years
Past month, days sick enough to miss class/work
Considered/dropped out due to health problems
Considered/dropped out due to medical expenses
Ever been diagnosed with ADHD/ADD
Currently being treated for ADHD/ADD with medication
Ever seriously thought about suicide
Past 12 months, ever seriously consider suicide
Past 12 months, made suicide attempts
Times used the Health Center past year
Health improve because of your visit
Use services again if needed
Why not used services past year
SHC can improve services
Cost of SHC compared to other health services
Currently covered by health insurance
Who pays your health insurance
Often found unable to afford needed health care
All UO students be required to have health insurance
Prefer increase in prepaid/increased charges
Willing to pay $25 per term more for cost of care not available at HC
Know the Health Center is open on weekends
Agree with extending its services to partners of UO students
Extend services, unmarried partners of UO students
Extend services, children of UO students
Extend services, UO faculty
Extend services, UO staff
Extend services, UO alumni
Extend services, students of nearby colleges
Class status
Member of athletics team
Age
Living arrangement
Member of a fraternity/sorority
Race
International student
Financial aid
Pell grant
Currently working for pay
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