Module O 162 M o d u l e O – E n d o f q u e s t i o n n a i r e Civil status of social security eligibility collection As mentioned in the brochure you received, your civil status was collected so as to gather useful information about your healthcare consumption in the last twelve months directly from the National healthcare fund and to carry out long-term studies on life expectancy. This information will then be deleted and will not appear in the strictly anonymous files at our researchers’ disposition. This data collection is only carried out for those persons having given their consent. If you use another social healthcare insurance (sécurité sociale) number (because you are covered under their policy) for your healthcare consummation, the corresponding civil status must also be collected. OQUINIR. Is the sécurité sociale number you use… ? 1. (cid:135) Your own sécurité sociale number 3. (cid:135) No, it’s not yours, you are covered under their policy (particularly for children) fill out the eligibility file if the answer is 2 *****filter: if OQUINIR = 2 ***** Can you give me: ONOM1. The last name of the person (the maiden name for women) whose sécurité sociale number is used for your reimbursements? ______________________________ (cid:135) Refuses to answer (cid:135) Doesn’t know If Refuses to answer or Doesn’t know in ONOM1 => go to question OACNIR2B OPRENOM1. Their first name? ______________________________ (cid:135) Refuses to answer (cid:135) Doesn’t know OSEXE1. Their gender 1. (cid:135) Male? 2. (cid:135) Female? ODATENAIS1. Their date of birth? |__|__| |__|__| |__|__|__|__| (cid:135) Refuses to answer (cid:135) Doesn’t know OPAYS1NAIS1. Their place of birth? 1. (cid:135) In France (metropolitan or French overseas departments and territories)?… =>go to OCOMNAIS1 2. (cid:135) Abroad?………………………………….=> go to OPAYS1NAIS2
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