Client Service

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SOCIODEMOGRAPHIC INFORMATION 1.1 Date of birth 1.2 Sex / Date of interview d d d d / m m m m / y y y y / 1 Female 2 Male 1.3 Marital status (from a legal perspective) 1 2 3 4 5 Single/unmarried Married Separated Divorced Widow/widower 9 Not known 1.4 1.5 What is your ethnic group (Refer to manual for assistance) Ethnic group Country of birth Country (Refer to coding sheet) 1.6 Mother tongue 1 National language 2 Other language (but having good knowledge of national language) 3 Other language (and having poor or no knowledge of national language) 1.7 1.8 Number of years of schooling in general education Highest completed level of education Number of years schooling 1 2 3 4 Primary education or less Secondary education Tertiary / further education Other general education 9 Not known 1.9 What further education or Specific vocational training ( 1 year) vocational training have you Specific vocational training ( 1 year) completed or are doing now Tertiary level qualification /diploma (Tick all boxes that apply) University degree (undergraduate) University higher degree (postgraduate) Other vocational training 1 Version 24 November 1997 CSRI CPA/10 years on 1.10 What is the client’s diagnosis 1.11 What is the client’s current legal status / 1.12 How much time, in total, has the client spent in long-stay hospitals years / months 1.13 How many times, in total, has the client been compulsory admitted 2..

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