Data Collection Forms and QxQs (Current)

Code Version Title Date Form QxQsort descending
SPU 2.0 Sputum Slide Form 02/01/2018 PDF icon PDF PDF icon PDF
AES 2.0 Adverse Events Form 10/25/2017 PDF icon PDF PDF icon PDF
ANT 2.0 Anthropometry Form 02/13/2018 PDF icon PDF PDF icon PDF
DEM 4.0 Demographic Information Form 10/23/2017 PDF icon PDF PDF icon PDF
ECF 2.0 e-Cigarette Use Assessment for Follow-Up Form 03/08/2018 PDF icon PDF PDF icon PDF
HGS 1.0 Hand Grip Strength Form 09/20/2017 PDF icon PDF PDF icon PDF
MCQ 2.0 Questionnaire for Ease and Cough and Sputum Clearance 10/09/2017 PDF icon PDF PDF icon PDF
RSW 2.0 Reason for Study Withdrawal Form 11/08/2017 PDF icon PDF PDF icon PDF
SPB 1.0 Short Physical Performance Battery 02/05/2018 PDF icon PDF PDF icon PDF
CAT 2.0 COPD Assessment Test 11/03/2017 PDF icon PDF PDF icon PDF
MHF 3.0 Medical History Form for Follow-Up 01/09/2018 PDF icon PDF PDF icon PDF
MRC 2.0 Modified Medical Research Council Dyspnea Scale 10/09/2017 PDF icon PDF PDF icon PDF
VSA 2.0 Veterans Specific Activity Questionnaire 12/14/2017 PDF icon PDF PDF icon PDF
BIO 4.0 Biospecimen Collection Form 05/22/2018 PDF icon PDF PDF icon PDF
SDF 2.0 Spirometry Data Form 10/09/2017 PDF icon PDF PDF icon PDF
EHA 2.0 Employment History Form for Follow-Up 12/18/2017 PDF icon PDF PDF icon PDF
FCT 2.0 Functional Assessment of Chronic Illness Therapy-Fatigue 03/13/2018 PDF icon PDF PDF icon PDF
SFH 3.0 SF12 Health Survey 11/07/2017 PDF icon PDF PDF icon PDF
SGR 3.0 St. George's Respiratory Questionnaire 10/24/2017 PDF icon PDF PDF icon PDF
FUQ 3.0 Follow-Up Phone Questionnaire 02/27/2018 PDF icon PDF PDF icon PDF
FEE 1.0 Follow-Up Exacerbation Extended Questionnaire 05/23/2018 PDF icon PDF PDF icon PDF
FEQ 1.0 Follow-Up Exacerbation Questionnaire 03/06/2018 PDF icon PDF PDF icon PDF
CBC 3.0 CBC Results Form 04/02/2019 PDF icon PDF PDF icon PDF
ITF 3.0 Informed Consent Tracking Form 06/04/2018 PDF icon PDF, PDF icon PDF PDF icon PDF
PLI 2.0 Phantom Lab ID Form 06/13/2018 PDF icon PDF PDF icon PDF
HDS 2.0 Hospital Anxiety and Depression Scale 10/09/2017 PDF icon PDF PDF icon PDF
LAB 2.0 Lab ID Form 12/13/2017 PDF icon PDF PDF icon PDF
CIF 3.0 Contact Information Form 01/31/2018 PDF icon PDF PDF icon PDF
PID 3.0 Personal Identifiers Form 01/09/2018 PDF icon PDF PDF icon PDF
RDF 2.0 Respiratory Disease and Smoke Exposure Questionnaire for Follow-Up 08/24/2018 PDF icon PDF PDF icon PDF
RRM 1.0 Revised Respiratory Medication Use Questionnaire 08/14/2018 PDF icon PDF PDF icon PDF
LYS 1.0 Lysate Lab ID Form 05/10/2018 PDF icon PDF PDF icon PDF
MUC 1.0 Mucin Lab ID Form 06/11/2018 PDF icon PDF PDF icon PDF
PAX 1.0 Paxgene Lab ID Form 05/09/2018 PDF icon PDF PDF icon PDF
SLI 1.0 Sputum Slide Lab ID Form 05/10/2018 PDF icon PDF PDF icon PDF
SLY 1.0 Sputolysin Lab ID Form 06/14/2018 PDF icon PDF PDF icon PDF
TEC 1.0 Temporary Exclusion Criteria Form 08/29/2018 PDF icon PDF PDF icon PDF
PFE 1.0 Pulmonary Function Eligibility Form 11/15/2017 PDF icon PDF PDF icon PDF
HIQ 2.0 Home Information Questionnaire 03/12/2018 PDF icon PDF PDF icon PDF
SMW 4.0 Six Minute Walk Test 11/19/2018 PDF icon PDF PDF icon PDF
CSF 1.0 Clinically Significant Findings Form 11/12/2018 PDF icon PDF PDF icon PDF
CTF 3.0 Image Acquisition Form for Follow-Up 11/12/2018 PDF icon PDF PDF icon PDF
BPF 3.0 Blood Pressure Form 11/05/2018 PDF icon PDF PDF icon PDF
ISP 4.0 Induced Sputum Worksheet 04/05/2019 PDF icon PDF PDF icon PDF
ISW 4.0 Induced Sputum Worksheet 04/18/2019 PDF icon PDF PDF icon PDF
SPW 6.0 Sputum Processing Worksheet 04/22/2019 PDF icon PDF PDF icon PDF
HBC 1.0 Hair and Buccal Collection Form 03/05/2019 PDF icon PDF PDF icon PDF
OSC 1.0 Oscillometry Data Form 06/19/2019 PDF icon PDF PDF icon PDF
EBC 1.0 Exhaled Breath Condensate Collection Form 06/11/2019 PDF icon PDF PDF icon PDF
NQS 1.0 Nutrtionquest Questionnaire ID Form PDF icon PDF
SKF 1.0 Stool Kit ID Form PDF icon PDF
STL 1.0 Stool Sample Collection Form PDF icon PDF