TOO FAR A
INCONVENIENT SERVICE HOUR B
UNPLEASANT STAFF C
LACK OF EXPERIENCED STAFF D
LACK OF PRIVACY E
INADEQUATE DRUG SUPPLY F
LONG WAITING TIME G
SERVICE TOO EXPENSIVE H
RELIGIOUS REASON I
NOT NEEDED J
DID NOT KNOW OF NEED FOR CARE K
UNABLE TO GO/NOT PERMITTED TO LEAVE HOUSE L
DID NOT KNOW OF A PLACE M
OTHER (SPECIFY)____ X

NOT NECESSARY A
COSTS TOO MUCH B
TOO FAR C
NO TRANSPORT D
NO ONE TO GO WITH E
SERVICE NOT GOOD F
NO TIME TO GO G
DID NOT KNOW WHERE TO GO H
DID NOT WANT TO SEE A MALE DOCTOR I
LONG WAITING TIME J
NOT ALLOWED TO GO K
OTHER ____ X