| 93667-4 | WellRx Questionnaire - revised |
| 93668-2 | Did you or others you live with eat smaller meals or skip meals because you didn't have money for food in the past 2 months (qualitative) |
| 93669-0 | Are you homeless or worried that you might be in the future (qualitative) |
| 93670-8 | Do you have trouble paying for your gas or electricity bills (qualitative) |
| 93671-6 | Do you have trouble finding or paying for transportation (qualitative) |
| 93672-4 | Do you need daycare, or better daycare, for your kids (qualitative) |
| 93673-2 | Are you unemployed or without regular income (qualitative) |
| 93674-0 | Do you need help finding a better job (qualitative) |
| 93675-7 | Do you need help getting more education (qualitative) |
| 93676-5 | Are you concerned about someone in your home using drugs or alcohol (qualitative) |
| 93678-1 | Have you been at the emergency department more than twice in the last 6 months (qualitative) |
| 93682-3 | Do you feel unsafe in your daily life (qualitative) |
| 93683-1 | Is anyone in your home threatening or abusing you (qualitative) |