STUDY GREEN FORM
1. HAVE YOU GONE EXTERIOR IN AUDITING? _________
(Check to make sure the read is a valid read and
not a
protest or false read. If it is valid, indicate it.
If valid, the C/S is to determine how to handle the Out-Int.
2. HAS YOUR INT HANDLING BEEN MESSED UP? _________
(Assess and handle Recall Int RD Correction List.
If Int
correction has already been done have
C/S determine what's next.
(An FES should be done. When all errors are corrected,
the C/S may order the Recall Int RD.)
3. HAS THERE BEEN A LIST ERROR? _________
(Find out which list and handle with an L4BRB.)
4. ON STUDY HAVE YOU BEEN GIVEN A WRONG WHY? _________
(L4BRB and handle.)
5. ON STUDY DO YOU HAVE AN ARC BREAK? _________
(Assess E/S to F/N.)
6. ON STUDY DO YOU HAVE AN ARC BREAK OF LONG DURATION?
_________
(Assess E/S to F/N.)
7. ON STUDY DO YOU HAVE A PROBLEM? _________
(Itsa E/S itsa to F/N.)
8. ON STUDY ARE YOU WITHHOLDING ANYTHING? _________
(Get what, pull it, find out who missed it. E/S to
F/N.)
9. DID YOU EVER KNOWINGLY GO BY MISUNDERSTOOD WORDS?
_________
(Handle as a withhold E/S to F/N.
Clear any misunderstoods
found, each to F/N.)
10. DO YOU HAVE A MISSED WITHHOLD OF GOING PAST
MISUNDERSTOODS? _________
(Pull the missed withhold E/S to F/N.
Then clear each
misunderstood he went past, each word to F/N.)
11. HAVE YOU HAD EARLY BAD AUDITING? _________
(L1C Method 3 "On early auditing...")
12. WAS WORD CLEARING DONE IN THE MIDDLE OF A/O INCOMPLETE AUDITING CYCLE? _________
(2WC to F/N. Get which cycle pc is on and by folder
inspection evaluate which one needs to
be completed first- make sure it is fully
noted on the pc's program to
complete word clearing if the other action is
handled first.)
13. DO YOU HAVE AN INCOMPLETE TRs COURSE? _________
(2WC to F/N. Program to complete TRs course.)
14. ON STUDY HAVE YOU HAD TROUBLE WITH CLEARING WORDS?
_________
(Itsa E/S itsa to F/N. WCCL if needed.
Pgm for WdCl Intnsive or repair/flattening of it if already done.)
15. ON STUDY IS THERE BY-PASSED CHARGE ON WORD CLEARING?
_________
(WCCL and handle.)
16. DO YOU HAVE TROUBLE WITH WORDS? _________
(Itsa E/S itsa to F/N. WCCL if needed.
Pgm for WdCl Intensive or repair/flattening of it if already done.)
17. DO YOU HAVE MISUNDERSTOODS FROM YOUR EARLIER SCHOOLING?
_________
(Itsa E/S itsa to F/N. WCCL if needed.
Pgm for WdCl Intnsive or repair/flattening of it if already done.)
18. ON STUDY HAS YOUR WORD CLEARING BEEN MESSED UP? _________
(WCCL and handle.)
19. DON'T YOU WANT TO STUDY? _________
(Find out if there was a time
when he did want to study and S/O
invalidated this and clean it up. Otherwise ask, "Tell me about why
you don't want to study," and 2WC to F/N.)
20. HAS THERE BEEN NO AUDITING ON THE SUBJECT OF STUDY?
_________
(Itsa E/S itsa to F/N.)
21. HAVE YOU BEEN MADE TO STUDY BECAUSE S/O ELSE DEMANDED
IT? _________
(Itsa E/S itsa to F/N.)
22. HAVE YOU HAD TO STUDY WHEN YOU DIDN'T WANT TO?
_________
(Itsa E/S itsa to F/N.)
23. ON STUDY HAS THERE BEEN AN INJUSTICE? _________
(Itsa E/S itsa to F/N.)
24. HAS ETHICS ACTION EVER BEEN TAKEN ON YOU FOR NOT APPLYING
STUDY TECH? _________
(Itsa E/S itsa to F/N.)
25. SHOULD ETHICS ACTION HAVE BEEN TAKEN ON YOU FOR FAILING
TO APPLY STUDY TECH? _________
(Itsa E/S itsa to F/N.)
26. HAVE YOU BEEN THREATENED INTO STUDYING? _________
( Quad Recalls on being threatened into
studying.
F1: Recall a time you were threatened into studying.
F2: Recall a time you threatened A/O into studying.
F3: Recall a time others threatened others into studying.
F0: Recall a time you threatened yourself into studying.)
27. HAVE YOU BEEN PUNISHED INTO STUDYING? _________
(Quad Recalls on being threatened into
studying.
F1: Recall a time you were threatened into studying.
F2: Recall a time you threatened A/O into studying.
F3: Recall a time others threatened others into studying.
F0: Recall a time you threatened yourself into studying.)
28. IS THERE PAIN CONNECTED WITH STUDY? _________
( Quad Recalls on pain connected to study.
F1: Recall a time pain was connected to study.
F2: Recall a time you caused A/O to have pain
connected with study.
F3: Recall a time others caused others to have pain
connected with study.
F0: Recall a time you caused yourself to have pain
connected with study.)
29. HAVE YOU BEEN MADE TO STUDY WHEN YOU HAD NO WILLINGNESS
TO KNOW? _________
(Itsa E/S itsa to F/N.)
30. HAVE YOU BEEN MADE TO FEEL BAD ABOUT DOING POORLY IN
STUDY? _________
(Itsa E/S itsa to F/N.)
31. HAVE YOU BEEN ASHAMED OF YOUR SCHOOL GRADES? _________
(Itsa E/S itsa to F/N.)
32. HAVE YOU BEEN MADE TO FEEL LIKE A SOCIAL OUTCAST BECAUSE
YOU DIDN'T DO WELL IN SCHOOL? _________
(Itsa E/S itsa to F/N.)
33. HAVE YOU BEEN PUSHED TO GET GOOD GRADES? _________
(Itsa E/S itsa to F/N.)
34. HAVE YOU BEEN ASHAMED OF NOT FINISHING HIGH SCHOOL?
_________
(Itsa E/S itsa to F/N.)
35. WERE YOU MADE TO THINK YOU'D FAILED BECAUSE YOU DIDN'T
GO TO COLLEGE (UNIVERSITY)? _________
(Itsa E/S itsa to F/N.)
36. HAS S/O TOLD YOU YOU WERE A BAD STUDENT? _________
(Itsa E/S itsa to F/N.)
37. HAVE YOU BEEN RIDICULED IN FRONT OF OTHER STUDENTS?
_________
(Itsa E/S itsa to F/N.)
38. HAS THERE BEEN NO ONE TO SUPERVISE YOUR STUDY? _________
(Itsa E/S itsa to F/N.)
39. ON STUDY HAS NO ONE SHOWN ANY INTEREST IN YOUR PROGRESS?
_________
(Itsa E/S itsa to F/N.)
40. HAVE YOU HAD BAD STUDY SUPERVISION? _________
(Itsa E/S itsa to F/N.)
41. ON STUDY HAVE YOU HAD BAD COACHING? _________
(Itsa E/S itsa to F/N.)
42. ON STUDY HAVE YOU BEEN INVALIDATED? _________
(Itsa E/S itsa to F/N.)
43. HAVE YOU KNOWN IT WOULD NEVER DO ANY GOOD TO STUDY?
_________
(Find out if there was a time when he felt it did matter if
he studied and S/O
invalidated this. If so, clean it up. Otherwise ask,
"Tell
me about why it would never do any good to study," and 2WC to F/N.)
44. ON STUDY HAVE YOU INVALIDATED YOURSELF? _________
(Itsa E/S itsa to F/N.)
45. HAS S/O TOLD YOU THAT YOU DON'T KNOW HOW TO STUDY?
_________
(Itsa E/S itsa to F/N.)
46. HAVE YOU BEEN FLUNKED WHEN YOU SHOULDN'T HAVE BEEN?
_________
(Indicate. Rehab the point when he knew he had it.)
47. ON STUDY HAD YOU MADE IT AND S/O SAID YOU HADN'T?
_________
(Indicate. Rehab the point when he made it.)
48. HAS S/O INVALIDATED WHAT YOU STUDIED? _________
(Itsa E/S itsa to F/N.)
49. ON STUDY HAVE YOU BEEN MADE TO FEEL STUPID ABOUT A
SUBJECT? _________
(Itsa E/S itsa to F/N.)
50. HAVE YOU BEEN MADE WRONG BY A TEACHER? _________
(Itsa E/S itsa to F/N.)
51. ON STUDY HAS S/O TRIED TO CORRECT YOU WHEN THERE WAS N/G WRONG? _________
(Itsa E/S itsa to F/N.)
52. HAVE YOU BEEN PREVENTED FROM STUDYING? _________
(Itsa E/S itsa to F/N.)
53. HAVE OTHERS PREVENTED YOU FROM KNOWING? _________
(Itsa E/S itsa to F/N.)
54. HAVE YOU BEEN REPRIMANDED FOR WANTING TO KNOW? _________
(Itsa E/S itsa to F/N.)
55. WERE YOU NOT ALLOWED TO OBSERVE, UNDERSTAND AND DO?
_________
(Itsa E/S itsa to F/N.)
56. COULDN'T YOU STUDY BECAUSE OF THE DEMANDS OF A JOB OR
POST? _________
(Itsa E/S itsa to F/N.)
57. WAS THERE NO TIME TO STUDY? _________
(Itsa E/S itsa to F/N.)
58. HAS THERE BEEN S/G WRONG WITH THE STUDY
ENVIRONMENT? _________
(Itsa E/S itsa to F/N.)
59. HAVE YOU BEEN DISTURBED WHILE STUDYING? _________
(Itsa E/S itsa to F/N.)
60. ON STUDY WAS S/O MAD AT YOU? _________
(Itsa E/S itsa to F/N.)
61. ON STUDY IS THERE AN ENGRAM IN RESTIMULATION? _________
(Indicate. Assess an L3RH and handle.) (On Clears or above,
simply indicate the item. If no F/N, assess an L3RH but do no
more than indicate
the reading item[s]. Do NOT run any Engrams.)
62. DO YOU HAVE AN ENGRAM MATCHING PRESENT TIME STUDY?
_________
(If so, run it out Narrative R3RA Triple or Quad.) (On Clears
or above,
simply indicate the item. If no F/N, assess an L3RH but do no more
than indicate the reading item[s]. Do NOT run any Engrams.)
63. HAVE YOU BEEN OVERWHELMED ON STUDY? _________
(Itsa E/S itsa to F/N.)
64. HAVE YOU BEEN CONNECTED TO S/O WHO DIDN'T WANT YOU
TO LEARN? _________
(Itsa E/S itsa to F/N.)
65. HAVE YOU BEEN MADE TO FEEL A SUBJECT WAS DANGEROUS?
_________
(Itsa E/S itsa to F/N.)
66. DOESN'T STUDY TECH WORK ON YOU? _________
(Find out what didn't work and correct it to F/N VGIs and a
win.)
67. ON STUDY IS THERE S/G YOU'RE CONFUSED ABOUT?
_________
(Find out what it is and clear it up to F/N and VGIs.)
68. ON STUDY HAVE YOU GONE PAST MISUNDERSTOODS? _________
(Assess a WCCL and handle.)
69. HAVE YOU FAILED TO USE STUDY TECH? _________
(2WC to find out what he hasn't used. Itsa E/S
itsa to F/N,
then clear up any misunderstoods that have come up.)
70. ON STUDY WERE THERE NO DICTIONARIES? _________
(Itsa E/S itsa to F/N.)
71. ON STUDY WERE THE DICTIONARIES INADEQUATE? _________
(Itsa E/S itsa to F/N.)
72. ON STUDY WERE THE DICTIONARIES INCOMPREHENSIBLE?
_________
(Itsa E/S itsa to F/N.)
73. ON STUDY HAVE MATERIALS CONTAINED INCORRECT DATA?
_________
(Itsa E/S itsa to F/N.)
74. DID MATERIALS YOU TRIED TO STUDY CONTAIN OMITTED DATA?
_________
(Itsa E/S itsa to F/N.)
75. ON STUDY WERE YOU GIVEN NO TEXT? _________
(Itsa E/S itsa to F/N.)
76. ON STUDY WERE YOU GIVEN A FALSE TEXT? _________
(Itsa E/S itsa to F/N.)
77. HAVE YOU BEEN UNABLE TO FIND THE DATA YOU WANTED IN
TEXTBOOKS? _________
(Itsa E/S itsa to F/N.)
78. HAS THE DATA IN BOOKS BEEN INCOMPREHENSIBLE? _________
(Itsa E/S itsa to F/N.)
79. HAVE YOU WANTED TO LEARN S/G BUT YOU COULDN'T GET
IT OUT OF A TEXTBOOK? _________
(Itsa E/S itsa to F/N.)
80. HAVE YOU STUDIED S/G THAT WAS FALSE? _________
(Itsa E/S itsa to F/N.)
81. HAVE THERE BEEN DISAGREEMENTS WITH DATA? _________
(Itsa E/S itsa to F/N.)
82. ON STUDY HAS ANYONE TAUGHT OR GIVEN YOU FALSE DATA?
_________
(Itsa E/S itsa to F/N.)
83. ON STUDY HAVE YOU RECEIVED VERBAL DATA? _________
(Itsa E/S itsa to F/N.)
84. HAS S/O MADE YOU STUDY IMPROPERLY? _________
(Itsa E/S itsa to F/N.)
85. ON STUDY HAVE YOU BEEN MADE TO DO THINGS WRONG? _________
(Itsa E/S itsa to F/N.)
86. ON STUDY HAVE YOU BEEN PREVENTED FROM USING YOUR OWN
JUDGMENT? _________
(Itsa E/S itsa to F/N.)
87. HAVE THERE BEEN ARBITRARY RULES ABOUT HOW YOU STUDY?
_________
(Itsa E/S itsa to F/N.)
88. WAS THERE NO REASON FOR LEARNING S/G? _________
(Itsa E/S itsa to F/N.)
89. IS THERE ANY REASON YOU SHOULD REMAIN IGNORANT? _________
(2WC E/S to F/N.)
90. IS KNOWLEDGE OF NO VALUE? _________
(2WC E/S to F/N.)
91. IS THERE S/G OTHERS SHOULDN'T KNOW? _________
(2WC E/S to F/N.)
92. HAVE YOU EVER WILLFULLY KEPT YOURSELF FROM BEING
INFORMED? _________
(2WC E/S to F/N.)
93. HAVE YOU HAD TO STUDY S/G YOU WOULD NEVER NEED TO
APPLY? _________
(Itsa E/S itsa to F/N.)
94. COULDN'T YOU GET RESULTS WITH WHAT YOU LEARNED?
_________
(Itsa E/S itsa to F/N.)
95. HAVE YOU STUDIED ONLY TO PASS AN EXAM? _________
(Itsa E/S itsa to F/N.)
96. HAVE YOU NEVER APPLIED WHAT YOU LEARNED? _________
(Itsa E/S itsa to F/N.)
97. HAVE YOU STUDIED FOR SOME OTHER REASON? _________
(Itsa E/S itsa to F/N.)
98. WAS THERE NO CHOICE ABOUT WHAT YOU STUDIED? _________
(Itsa E/S itsa to F/N.)
99. DID YOU HAVE TO STUDY WHEN YOU WANTED TO DO S/G ELSE? _________
(Itsa E/S itsa to F/N.)
100. HAVE YOU HAD TO STUDY S/G YOU HAD NO INTEREST IN?
_________
(Itsa E/S itsa to F/N.)
101. HAVE YOU HAD TO STUDY A SUBJECT THAT WAS OF NO USE?
_________
(Itsa E/S itsa to F/N.)
102. DO YOU GET ANGRY AT THINGS YOU DON'T UNDERSTAND?
_________
(Itsa E/S itsa to F/N.)
103. HAVE YOU HAD TO LEARN TOO MANY THINGS BEFORE YOU COULD
LEARN WHAT YOU WANTED TO? _________
(Itsa E/S itsa to F/N.)
104. DID S/G SEEM TOO DIFFICULT TO LEARN? _________
(Itsa E/S itsa to F/N.)
105. HAVE YOU HAD TO STUDY TOO MUCH TOO FAST? _________
(Itsa E/S itsa to F/N.)
106. WERE YOU ASKED TO DO THINGS YOU COULDN'T STUDY?
_________
(Itsa E/S itsa to F/N.)
107. WERE YOU ASKED TO LEARN THE WHOLE SUBJECT AT ONCE?
_________
(Itsa E/S itsa to F/N.)
108. DID S/O EXPECT YOU TO KNOW IT ALL AT ONCE? _________
(Itsa E/S itsa to F/N.)
109. DO YOU LEARN SLOWLY BUT YOU'VE BEEN MADE TO STUDY
FAST? _________
(Itsa E/S itsa to F/N.)
110. DO YOU LEARN FAST BUT YOU'VE BEEN MADE TO STUDY
SLOWLY? _________
(Itsa E/S itsa to F/N.)
111. WERE YOU A FAST STUDY AND PEOPLE SAID YOU WERE SLOW?
_________
(Itsa E/S itsa to F/N.)
112. HAVE THE BASICS OF A SUBJECT BEEN OMITTED? _________
(Itsa E/S itsa to F/N.)
113. HAVE STUDY MATERIALS BEEN UNAVAILABLE? _________
(Itsa E/S itsa to F/N.)
114. WAS IT ALL DOINGNESS AND NO REASON WHY? _________
(Itsa E/S itsa to F/N.)
115. HAS IT BEEN ALL SIGNIFICANCE AND NO DOINGNESS? _________
(Itsa E/S itsa to F/N.)
116. ON STUDY WAS A GRADIENT TOO STEEP? _________
(Itsa E/S itsa to F/N.)
117. ON STUDY DID YOU SKIP A GRADIENT? _________
(Itsa E/S itsa to F/N.)
118. HAVE YOU HAD TO CONTINUE STUDYING WHEN YOU ALREADY KNEW
IT? _________
(Indicate. Rehab the point where he knew it.)
119. ON STUDY HAS THERE BEEN A WRONG EMPHASIS? _________
(Itsa E/S itsa to F/N.)
120. DO YOU HAVE OVERTS AGAINST STUDY? _________
(Get what he did, who missed it, E/S to F/N.)
121. HAVE YOU COMMITTED OVERTS BY REASON OF STUDY? _________
(Get what he did, who missed it, E/S to F/N.)
122. HAVE YOU COMMITTED CRIMES IN SCHOOL? _________
(Get what he did, who missed it, E/S to F/N.)
123. DID YOU EVER DO ANYTHING IN STUDY THAT YOU FELT BAD
ABOUT? _________
(Get what he did, who missed it, E/S to F/N.)
124. ON STUDY DID YOU EVER DO ANYTHING BAD WHICH YOU
JUSTIFIED? _________
(Get what he did, who missed it, E/S to F/N.)
125. HAVE YOU VIOLATED STUDENT RULES? _________
(Get what he did, who missed it, E/S to F/N.)
126. HAVE YOU GIVEN VERBAL DATA OR DEFINITIONS TO OTHERS?
_________
(Get what he did, who missed it, E/S to F/N.)
127. HAVE YOU COMMITTED OVERTS ON A TEACHER OR SUPERVISOR?
_________
(Get what he did, who missed it, E/S to F/N.)
128. HAVE YOU BEEN CRITICAL OF STUDY OR TEACHERS BEHIND THEIR
BACKS? _________
(Get what he did, who missed it, E/S to F/N.)
129. HAVE YOU CAUSED AN UPSET IN A COURSE ROOM? _________
(Get what he did, who missed it, E/S to F/N.)
130. HAVE YOU LIED TO A TEACHER OR SUPERVISOR? _________
(Get what he did, who missed it, E/S to F/N.)
131. HAVE YOU MADE TROUBLE FOR A TEACHER OR SUPERVISOR?
_________
(Get what he did, who missed it, E/S to F/N.)
132. HAVE YOU REFUSED TO LET OTHERS HELP YOU LEARN? _________
(Get what he did, who missed it, E/S to F/N.)
133. HAVE YOU COMMITTED OVERTS ON STUDENTS? _________
(Get what he did, who missed it, E/S to F/N.)
134. HAVE YOU MADE A/O FEEL STUPID? _________
(Get what he did, who missed it, E/S to F/N.)
135. HAVE YOU MADE OTHERS FEEL ASHAMED OF THEIR SCHOOL
GRADES? _________
(Get what he did, who missed it, E/S to F/N.)
136. HAVE YOU DAMAGED STUDY MATERIALS OR BOOKS? _________
(Get what he did, who missed it, E/S to F/N.)
137. HAVE YOU STOLEN STUDY MATERIALS OR BOOKS? _________
(Get what he did, who missed it, E/S to F/N.)
138. DO YOU HAVE UNPAID DEBTS FOR COURSES YOU'VE TAKEN?
_________
(Get what he did, who missed it, E/S to F/N.)
139. HAVE YOU OMITTED DOING PARTS OF A CHECKSHEET OR COURSE?
_________
(Get what he did, who missed it, E/S to F/N.)
140. HAVE YOU PASSED A CHECKSHEET, TEST OR EXAM FALSELY?
_________
(Get what he did, who missed it, E/S to F/N.)
141. DID YOU BRIBE ANYONE IN ANY WAY TO PASS YOU? _________
(Get what he did, who missed it, E/S to F/N.)
142. ON STUDY HAVE YOU CHEATED? _________
(Get what he did, who missed it, E/S to F/N.)
143. ON STUDY HAVE YOU TAKEN CREDIT FOR S/G YOU DIDN'T
DO? _________
(Get what he did, who missed it, E/S to F/N.)
144. ON STUDY HAVE YOU FAILED TO DO HOMEWORK OR ASSIGNMENTS?
_________
(Get what he did, who missed it, E/S to F/N.)
145. HAVE YOU FALSIFIED YOUR STUDY STATS? _________
(Get what he did, who missed it, E/S to F/N.)
146. HAVE YOU FALSELY ATTESTED TO COURSE COMPLETIONS?
_________
(Get what he did, who missed it, E/S to F/N.)
147. HAVE YOU PRETENDED YOU'VE STUDIED WHEN YOU HAVEN'T?
_________
(Get what he did, who missed it, E/S to F/N.)
148. HAVE YOU STUDIED BUT NOT INTENDED TO LEARN? _________
(Get what he did, who missed it, E/S to F/N.)
149. WHILE ON STUDY HAVE YOU DONE S/G ELSE INSTEAD?
_________
(Get what he did, who missed it, E/S to F/N.)
150. DID YOU STUDY OR STAY IN SCHOOL TO AVOID HAVING TO DO S/G ELSE? _________
(Get what he did, who missed it, E/S to F/N.)
151. ON STUDY HAVE YOU NOT PAID ATTENTION? _________
(Get what he did, who missed it, E/S to F/N.)
152. HAVE YOU SKIPPED GOING TO STUDY? _________
(Get what he did, who missed it, E/S to F/N.)
153. HAVE YOU NOT GONE TO SCHOOL WHEN YOU WERE SUPPOSED TO?
_________
(Get what he did, who missed it, E/S to F/N.)
154. HAVE YOU FALSELY ATTESTED TO COURSE PREREQUISITES?
_________
(Get what he did, who missed it, E/S to F/N.)
155. HAVE YOU PRETENDED TO HAVE STUDIED THINGS YOU HADN'T?
_________
(Get what he did, who missed it, E/S to F/N.)
156. HAVE YOU DONE S/G THAT MAKES YOU NOT DESERVE
STUDY? _________
(Get what he did, who missed it, E/S to F/N.)
157. HAVE YOU STUDIED S/G SO THAT YOU COULD DO HARM?
_________
(Get what he did, who missed it, E/S to F/N.)
158. HAVE YOU PRETENDED TO KNOW A SUBJECT? _________
(Get what he did, who missed it, E/S to F/N.)
159. HAVE YOU ALTERED STUDY TECH? _________
(Get what he did, who missed it, E/S to F/N.)
160. HAVE YOU CONVINCED OTHERS IT WAS USELESS TO STUDY?
_________
(Get what he did, who missed it, E/S to F/N.)
161. HAVE YOU TURNED STUDENTS AGAINST THEIR TEACHERS?
_________
(Get what he did, who missed it, E/S to F/N.)
162. DID YOU EVER THINK OF STARTING A STUDENT REVOLT?
_________
(Get what he did, who missed it, E/S to F/N.)
163. HAVE YOU TRIED TO GET OTHER STUDENTS TO REVOLT?
_________
(Get what he did, who missed it, E/S to F/N.)
164. HAVE YOU GONE TO SCHOOL JUST TO MAKE TROUBLE? _________
(Get what he did, who missed it, E/S to F/N.)
165. DO YOU HAVE EYESTRAIN OR BAD EYESIGHT? _________
(2WC to F/N. Note for C/S.)
166. ON STUDY DO YOU HAVE TROUBLE WITH YOUR HEARING?
_________
(2WC to F/N. Note for C/S.)
167. IN STUDY HAS S/G BEEN OVERRUN? _________
(Find out what and rehab.)
168. WAS THERE N/G WRONG WITH STUDY IN THE FIRST PLACE?
_________
(Indicate. If no F/N, rehab or date/locate.)
169. IS THIS LIST AN UNNECESSARY ACTION? _________
(Indicate. If no F/N, rehab or date/locate.)
170. HAVE YOU EVER FELT YOU COULD STUDY? _________
(Rehab this point.)
A/O = ANOTHER
S/G = SOMETHING
S/O = SOMEONE
N/G =
NOTHING