1. Is this information relevant?

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* 1. Is this information relevant?

2. Do you understand this information?

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* 2. Do you understand this information?

3. What do you think about this information? Check all that apply.

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* 3. What do you think about this information? Check all that apply.

4. Will you use this information for yourself?

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* 4. Will you use this information for yourself?

4.1. [If yes*] How will you use this information for the person under your care (child, spouse or elderly parent)? Check all that apply.

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* 4.1. [If yes*] How will you use this information for the person under your care (child, spouse or elderly parent)? Check all that apply.

5. Do you expect any benefit for the person under your care (child, spouse or elderly parent) from using this information? Check all that apply.

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* 5. Do you expect any benefit for the person under your care (child, spouse or elderly parent) from using this information? Check all that apply.

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