Forms / Questionnaires and QxQ

This page is under construction.

The forms on this page can be organized based on administrative, data collection, or annual follow-up documents. The table is also sortable by Form Title and all of the other headers.

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Form Title V1 V1 QxQ V2 V2 QxQ V3 V3 QxQ V4 V4 QxQ
Ankle Arm Blood Pressure - ABP
Acculturation - ACE ACS ACE
Alcohol Use - ALE ALS ALE/ALS ALE ALS ALE
Anthropometry - ANT ANT ANT ANT ANT
Anthropometry Quality Control - AQC AQC AQC AQC
Audiometry Examination - AUD
Biospecimen Collection - BIO BIO BIO BIO BIO BIO
Claudication - CLE CLS CLE
Dietary Behavior - DBE DBS DBE
Economic - ECE ECS ECE
Individual Eligibility Checklist - ELE ELE
Family Cohesion - FCE FCS FCE
Health Care - HCE HCS HCE HCE HCS HCE HCE HCS HCE
Hearing Exam - HEE HES HEE
Hearing History - HHE HHS HHE
Household Screening - HRS HRS
Personal Identifiers - IDE IDS IDE IDE IDS IDE IDE IDS IDE
Personal Medical History - MHE MHS MHE MHE MHS MHE MHE MHS MHE
Medication Use - MUE MUS MUE MUE MUS MUE MUE MUS MUE
Neurocognitive Assessment - NEE NES
NIMHD Questionnaire NIMHD-E NIMHD-S NIMHD
Oral Health - OHE OHS OHE
Otoscopy - OTO
Physical Activity - PAE PAS PAE
Pregnancy Complications - PCE PCS PCE
Participant Disability Screen - PDE PDS PDE PDE PDS PDE
Participant Feedback - PFE PFS PFE
Phantom Form - PHT PHT PHT PHT PHT
Personal Information - PIE PIS PIE
Reproductive and Medical History - RME RMS RME RME RMS RME
Respiratory - RSE RSS RSE
Serious Adverse Event Form - SAE SAE SAE SAE SAE
Sitting Blood Pressure - SBP SBP SBP SBP SBP
Sociocultural - SCE SCS SCE
Socioeconomic / Occupation - OCE OCS OCE SEE SES SEE SEE SES
SF12v2 Health Survey - SFE SFS SFE
Sleep - SLE SLS SLE
Social Network - SNE SNS SNE
Social Support - SSE SSS SSE
Chronic Stress - STE STS STE
Tobacco Use - TBE TBS TBE TBE TBS TBE TBE TBS TBE
Tympanometry - TYM
Well-Being - WBE WBS WBE WBE WBS WBE
Weight History - WHE WHS WHE