Reading it in English Looking at pictures while someone explains □ □ it Reading it in Spanish Listening to someone explain new □ □ information Reading it in another language Other: ________________________ □ □ Looking at pictures with words □ What is the highest of school you have completed? Grades 6 to 8 Associates Degree □ □ Grades 9 to 12 Bachelors Degree □ □ GED Graduate Degree □ □ High School Diploma Other: ________________________ □ □ Some College Prefer not to say □ □ Comments: Yes No Does the patient have low health literacy*? *Yes is somewhat, often, or always on following question
□ Reading it in English □ Looking at pictures while someone explains it □ Reading it in Spanish □ Listening to someone explain new information □ Reading it in another language □ Other: ________________________ □ Looking at pictures with words What is the highest of school you have completed? □ Grades 6 to 8 □ Associates Degree □ Grades 9 to 12 □ Bachelors Degree □ GED □ Graduate Degree □ High School Diploma □ Other: ________________________ □ Some College □ Prefer not to say Comments: Does the patient have low health literacy*? Yes No *Yes is somewhat, often, or always on following question
10.1001stepsforward.2017.0109supp6.docx