CARDIA Study Exam Forms

• Forms Checklist (Form 00)

• Blood Pressure (Form 02)

• Blood Pressure Callibration (Form 02C)

• Sociodemographics (Form 03)

• Phlebotomy (Form 05)

• Phlebotomy-Delayed OGTT (Form 05A)

• Diet History Interview (Form 06)

• Alcohol Use (Form 07)

• Medical History (Form 08)

• Follow-up Questions for Aspirin (Form 09-MED-ASP)

• Follow-up Questions for Medications (Form 09-MED)

• Follow-up Questions for Birth Control Medication (Form 09-MED-BCP)

• Follow-up Questions for Ovarian Surgery (Form 09-OVA)

• Follow-up Questions for Pregnancy (Form 09-PREG)

• Follow-up Questions for Tuberculosis (Form 09-TB)

• Follow-up Questions for Tobacco (Form 09-TOB)

• Tobacco use (Form 10)

• History of Lung Problems (Form 12)

• Loneliness (Form 14B)

• Framingham Type A (Form 16)

• Non-Medical Drug Use(Form 17)

• Physical Activity (Form 18)

• Anthropometry (Form 20)

• Interim Health Care Contacts (Form 31)

• ADDENDUM 1 to Form 31 (Form 31a)

• ADDENDUM 2 to Form 31 (Form 31b)

• ADDENDUM 3 to Form 31 (Form 31c)

• ADDENDUM 4 to Form 31 (Form 31d)

• CES Depression (Form 36)

• Anger in Expression (Form 38)

• Diet Practices (Form 48)

• Urine (Form 51)

• Neighborhood Cohesion (Form 56)

• Social Support and Conflict (Form 62)

• Social Networks (Form 63)

• Chronic burden (Form 64)

• Quality of Life SF (Form 65)

• Subjective Standing (Form 66)

• Sleep Habits (Form 67)

• Women's Reproductive Health (Form 68)

• CT Screening (Form 73)

• Goal Striving Stress (Form 74)

• Caregiving Stress (Form 75)

• CT Exam Completion (Form 76)

• Carotid Ultrasound (Form 77)

• CSQ - medical history (Form 78)

• Dietary Habits (Form 79)

• Spirometry completion (Form 80)

• Non-attendence telephone survey (Form 83)

RETURN TO THE TOP OF PAGE

CARDIA Fitness Study Exam Forms

• CFS Forms Checklist (Form CFS)

• Graded Exercise Treadmill Test Rescheduling and Exclusion Criteria Form (Form 21)

• Graded Exercise Treadmill Test (Form 22)

• Neighborhood Environment Questionnaire (Form 81)

• Daily Activity Monitor Log (Form 82)

• DXA Encounter Form (Form 84)

• Activity Monitor Encounter Form (Form 85)

• Pedometer Log (Form 86)

RETURN TO THE TOP OF PAGE