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Appendix A
Multi‐Level Questions
Multi-Level questions are questions for which a YES response will trigger additional questions.
Level 1 Question/Text/Audio
309
Are you having any
problems with
urination?
311
Are you having trouble
controlling your blood
sugar?
313
Are you having any
dizziness?
315
Have you almost fallen
in the last day?
319
Has your doctor added,
deleted, or changed any
of your medication this
week?
322
Have you developed a
cough?
A - 8
Yes responses trigger the following:
Are you experiencing any burning with urination or increased
frequency?
Did you skip your prescribed diabetes medication today?
Was your most recent blood sugar lower than usual?
Are you having any difficulty walking or standing?
Are you having any dizziness or light headedness today?
Did you seek medical treatment for your dizziness or light
headedness?
Do you feel worse since starting your new medication?
Is your cough productive?
Is your sputum, mucus, or phlegm thicker today?
Is your sputum, mucus, or phlegm a different color today?
Do you feel that you may have a chest infection?
© 2014 Honeywell HomMed. All rights reserved.
P4820EN.04
4/16/14
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