|
PTA |
1.0 |
Phantom Acquisition and Transmittal Form |
10/26/2010 |
 PDF |
|
|
ECA |
1.0 |
eCigarette Use Assessment |
06/11/2014 |
PDF |
|
|
CCL |
1.0 |
Clinical Center Itinerary |
10/26/2010 |
PDF |
PDF |
|
CTA |
2.0 |
CT Image Acquisition and Transmittal Form |
02/17/2012 |
PDF |
PDF |
|
SPU |
3.0 |
Sputum Slide Form |
04/29/2021 |
PDF |
PDF |
|
ANT |
2.0 |
Anthropometry Form |
02/13/2018 |
PDF |
PDF |
|
DEM |
4.0 |
Demographic Information Form |
10/23/2017 |
PDF |
PDF |
|
HGS |
1.0 |
Hand Grip Strength Form |
09/20/2017 |
PDF |
PDF |
|
MCQ |
2.0 |
Questionnaire for Ease and Cough and Sputum Clearance |
10/09/2017 |
PDF |
PDF |
|
SPB |
1.0 |
Short Physical Performance Battery |
02/05/2018 |
PDF |
PDF |
|
CAT |
2.0 |
COPD Assessment Test |
11/03/2017 |
PDF |
PDF |
|
MHF |
3.0 |
Medical History Form for Follow-Up |
01/09/2018 |
PDF |
PDF |
|
MRC |
2.0 |
Modified Medical Research Council Dyspnea Scale |
10/09/2017 |
PDF |
PDF |
|
VSA |
2.0 |
Veterans Specific Activity Questionnaire |
12/14/2017 |
PDF |
PDF |
|
BIO |
4.0 |
Biospecimen Collection Form |
05/22/2018 |
PDF |
PDF |
|
SDF |
2.0 |
Spirometry Data Form |
10/09/2017 |
PDF |
PDF |
|
EHA |
2.0 |
Employment History Form for Follow-Up |
12/18/2017 |
PDF |
PDF |
|
FCT |
2.0 |
Functional Assessment of Chronic Illness Therapy-Fatigue |
03/13/2018 |
PDF |
PDF |
|
SFH |
3.0 |
SF12 Health Survey |
11/07/2017 |
PDF |
PDF |
|
SGR |
3.0 |
St. George's Respiratory Questionnaire |
10/24/2017 |
PDF |
PDF |
|
FEE |
1.0 |
Follow-Up Exacerbation Extended Questionnaire |
05/23/2018 |
PDF |
PDF |
|
FEQ |
1.0 |
Follow-Up Exacerbation Questionnaire |
03/06/2018 |
PDF |
PDF |
|
CBC |
3.0 |
CBC Results Form |
04/02/2019 |
PDF |
PDF |
|
PLI |
2.0 |
Phantom Lab ID Form |
06/13/2018 |
PDF |
PDF |
|
HDS |
2.0 |
Hospital Anxiety and Depression Scale |
10/09/2017 |
PDF |
PDF |
|
LAB |
2.0 |
Lab ID Form |
12/13/2017 |
PDF |
PDF |
|
CIF |
3.0 |
Contact Information Form |
01/31/2018 |
PDF |
PDF |
|
PID |
3.0 |
Personal Identifiers Form |
01/09/2018 |
PDF |
PDF |
|
RDF |
2.0 |
Respiratory Disease and Smoke Exposure Questionnaire for Follow-Up |
08/24/2018 |
PDF |
PDF |
|
RRM |
1.0 |
Revised Respiratory Medication Use Questionnaire |
08/14/2018 |
PDF |
PDF |
|
LYS |
1.0 |
Lysate Lab ID Form |
05/10/2018 |
PDF |
PDF |
|
MUC |
1.0 |
Mucin Lab ID Form |
06/11/2018 |
PDF |
PDF |
|
PAX |
1.0 |
Paxgene Lab ID Form |
05/09/2018 |
PDF |
PDF |
|
SLI |
1.0 |
Sputum Slide Lab ID Form |
05/10/2018 |
PDF |
PDF |
|
SLY |
1.0 |
Sputolysin Lab ID Form |
06/14/2018 |
PDF |
PDF |
|
PFE |
1.0 |
Pulmonary Function Eligibility Form |
11/15/2017 |
PDF |
PDF |
|
HIQ |
2.0 |
Home Information Questionnaire |
03/12/2018 |
PDF |
PDF |
|
SMW |
4.0 |
Six Minute Walk Test |
11/19/2018 |
PDF |
PDF |
|
CSF |
1.0 |
Clinically Significant Findings Form |
11/12/2018 |
PDF |
PDF |
|
CTF |
3.0 |
Image Acquisition Form for Follow-Up |
11/12/2018 |
PDF |
PDF |
|
BPF |
3.0 |
Blood Pressure Form |
11/05/2018 |
PDF |
PDF |
|
SPW |
6.0 |
Sputum Processing Worksheet |
04/22/2019 |
PDF |
PDF |
|
HBC |
1.0 |
Hair and Buccal Collection Form |
03/05/2019 |
PDF |
PDF |
|
OSC |
1.0 |
Oscillometry Data Form |
06/19/2019 |
PDF |
PDF |
|
BCT |
2.0 |
Bronchoscopy Informed Consent Tracking Form |
07/18/2019 |
PDF |
PDF |
|
BID |
2.0 |
Bronchoscopy Substudy Lab ID Form |
07/18/2019 |
PDF |
PDF |
|
BWF |
2.0 |
Bronchoscopy Substudy Withdrawal Form |
07/18/2019 |
PDF |
PDF |
|
BMB |
1.0 |
Bronchoscopy Substudy Mucin Brush BRN ID Form |
08/29/2019 |
PDF |
PDF |
|
BMU |
1.0 |
Bronchoscopy Substudy Mucin BRN ID Form |
08/29/2019 |
PDF |
PDF |
|
BSL |
1.0 |
Bronchoscopy Substudy Sputum Slide BRN ID Form |
08/29/2019 |
PDF |
PDF |
|
BSY |
1.0 |
Bronchoscopy Substudy Sputolysin BRN ID Form |
08/29/2019 |
PDF |
PDF |
|
EWF |
2.0 |
Exacerbation Substudy Withdrawal Form |
05/14/2019 |
PDF |
PDF |
|
ECT |
2.0 |
Exacerbation Informed Consent Tracking Form |
05/14/2019 |
PDF |
PDF |
|
EID |
2.0 |
Exacerbation Substudy Lab ID Form |
05/14/2019 |
PDF |
PDF |
|
ELY |
1.0 |
Exacerbation Substudy Lysate PEX ID Form |
08/29/2019 |
PDF |
PDF |
|
EMU |
1.0 |
Exacerbation Substudy Mucin PEX ID Form |
08/29/2019 |
PDF |
PDF |
|
EPX |
1.0 |
Exacerbation Substudy Paxgene PEX ID Form |
08/29/2019 |
PDF |
PDF |
|
ESL |
1.0 |
Exacerbation Substudy Sputum Slide PEX ID Form |
08/29/2019 |
PDF |
PDF |
|
ESY |
1.0 |
Exacerbation Substudy Sputolysis Slide PEX ID Form |
08/29/2019 |
PDF |
PDF |
|
NSC |
1.0 |
Nasal Swab Biospecimen Collection |
10/03/2019 |
PDF |
PDF |
|
SKF |
1.0 |
Stool Kit ID Form |
03/26/2019 |
PDF |
PDF |
|
ECF |
3.0 |
e-Cigarette Use Assessment for Follow-Up Form |
09/24/2019 |
PDF |
PDF |
|
BIE |
3.0 |
Bronchoscopy Substudy Inclusion/ Exclusion Criteria Form |
10/11/2019 |
PDF |
PDF |
|
EFA |
1.0 |
Exacerbation Substudy Follow-Up Assessment Form |
10/01/2019 |
PDF |
PDF |
|
ISW |
5.0 |
Induced Sputum Worksheet |
09/24/2019 |
PDF |
PDF |
|
EBI |
1.0 |
Exacerbation Substudy Biospecimen Collection Form |
09/25/2019 |
PDF |
PDF |
|
ISP |
5.0 |
Induced Sputum Worksheet |
09/24/2019 |
PDF |
PDF |
|
EBC |
1.0 |
Exhaled Breath Condensate Collection Form |
06/11/2019 |
PDF |
PDF |
|
BPW |
4.0 |
Bronchoscopy Specimen Processing Worksheet |
12/12/2019 |
PDF |
PDF |
|
EDD |
1.0 |
Exacerbation Daily Symptom Diary |
06/05/2019 |
PDF |
PDF |
|
EAF |
2.0 |
Exacerbation Assessment Form |
05/14/2019 |
PDF |
PDF |
|
EIW |
1.0 |
Exacerbation Substudy Induced Sputum Worksheet |
02/12/2020 |
PDF |
PDF |
|
EIP |
1.0 |
Exacerbation Substudy Induced Sputum Worksheet |
02/12/2020 |
PDF |
PDF |
|
ALD |
2.0 |
Aldrete Score Form |
01/06/2020 |
PDF |
PDF |
|
NQS |
1.0 |
Nutritonquest Questionnaire ID Form |
03/05/2019 |
PDF, PDF, PDF |
PDF |
|
BCW |
4.0 |
Bronchoscopy Specimen Collection Worksheet |
02/04/2020 |
PDF |
PDF |
|
HFB |
1.0 |
Blood Collection Form |
12/13/2019 |
PDF |
PDF |
|
HFS |
1.0 |
Screening Form |
01/30/2020 |
PDF |
PDF |
|
HFW |
1.0 |
Study Withdrawal Form |
01/21/2020 |
PDF |
PDF |
|
BWR |
1.0 |
Blood Work Results Form |
01/31/2020 |
PDF |
PDF |
|
KCC |
1.0 |
KCCQ-12 Cardiomyopathy Questionnaire |
02/13/2020 |
PDF |
PDF |
|
RDB |
1.0 |
Respiatory Disease and Smoke Exposure Questionnaire- Brief |
02/06/2020 |
PDF |
PDF |
|
SSW |
1.0 |
Exacerbation Substudy Spontaneous Sputum Processing Worksheet |
02/19/2020 |
PDF |
PDF |
|
NQT |
1.0 |
Nutritionquest Tracking Form |
04/29/2020 |
PDF |
PDF |
|
DCF |
2.0 |
Death Certificate Form |
05/05/2020 |
PDF |
PDF |
|
HFA |
1.0 |
Additional Medical History Form |
02/14/2020 |
PDF |
PDF |
|
COV |
1.0 |
COVID-19 Questionnaire Wave 1 |
05/28/2020 |
PDF |
PDF |
|
ITF |
4.0 |
Informed Consent Tracking Form |
05/28/2020 |
PDF |
PDF |
|
COP |
1.0 |
COVID-19 Questionnaire - Proxy |
06/10/2020 |
PDF |
PDF |
|
HCT |
1.0 |
Consent Tracking Form |
06/09/2020 |
PDF |
PDF |
|
AES |
2.0 |
Adverse Events Form |
01/09/2020 |
PDF |
PDF |
|
STL |
1.0 |
Stool Sample Collection Form |
12/12/2019 |
PDF, PDF |
PDF |
|
TEC |
2.0 |
Temporary Exclusion Criteria Form |
07/07/2020 |
PDF |
PDF |
|
ECH |
2.0 |
Echo Completion Form |
08/07/2020 |
PDF |
PDF |
|
ESR |
2.0 |
Cardiologist Safety Review Form- Echo |
08/21/2020 |
PDF |
PDF |
|
RSW |
2.0 |
Reason for Study Withdrawal Form |
11/08/2017 |
PDF |
PDF |
|
MRI |
1.0 |
MRI Pre-Completion Form |
10/02/2020 |
PDF |
PDF |
|
SSP |
1.0 |
Stress Scale Phone Assessment |
10/13/2020 |
PDF |
PDF |
|
OSR |
1.0 |
Oscillometry Reading Center Data Form |
11/24/2020 |
PDF |
PDF |
|
MRT |
2.0 |
MRI Tech Completion Form |
02/24/2021 |
PDF |
PDF |
|
IFI |
2.0 |
Informant Interview- Endpoints |
10/23/2020 |
PDF |
PDF |
|
PQE |
2.0 |
Physician Questionnaire- Endpoints |
12/02/2020 |
PDF |
PDF |
|
MRE |
1.0 |
MRI Exclusion Form |
12/02/2020 |
PDF |
PDF |
|
MSR |
2.0 |
Radiologist Safety Review Form- MRI |
11/12/2020 |
PDF |
PDF |
|
BLY |
1.0 |
Bronchoscopy Substudy Lysate BRN ID Form |
12/11/2020 |
PDF |
PDF |
|
HRA |
2.0 |
Hospital Record Abstraction Form- Endpoints |
11/25/2020 |
PDF |
PDF |
|
ETF |
2.0 |
Event Tracking Form- Endpoints |
01/05/2021 |
PDF |
PDF |
|
TEA |
2.0 |
Telephone Exacerbation Assessment Form |
03/02/2021 |
PDF |
PDF |
|
EPV |
1.0 |
Exacerbation Phone Visit Form (Baseline) |
03/03/2021 |
PDF |
PDF |
|
CAF |
2.0 |
Cancer Abstraction Form- Endpoints |
03/18/2021 |
PDF |
PDF |
|
ERF |
2.0 |
Event Review Form- Endpoints |
03/18/2021 |
PDF |
PDF |
|
ESS |
1.0 |
Exacerbation Substudy Spontaneous Sputum PEX ID Form |
03/18/2021 |
PDF |
PDF |
|
ENS |
1.0 |
Exacerbation Substudy Nasal Swab PEX ID Form |
03/08/2021 |
PDF |
PDF |
|
DBS |
1.0 |
C4R Dried Blood Spot Form |
03/18/2021 |
PDF |
PDF |
|
EBS |
1.0 |
Exacerbation Substudy Blood Spot PEX ID Form |
03/08/2021 |
PDF |
PDF |
|
CVI |
1.0 |
COVID ICD Form |
07/07/2021 |
PDF |
PDF |
|
CVQ |
1.0 |
COVID-19 Vaccine Questionnaire |
07/29/2021 |
PDF |
PDF |
|
CVT |
1.0 |
COVID Tracking Form |
02/07/2022 |
PDF |
PDF |
|
COF |
1.0 |
COVID-19 Questionnaire Wave 2 |
10/21/2021 |
PDF |
PDF |
|
FUQ |
4.0 |
Follow-Up Phone Questionnaire |
07/28/2022 |
PDF |
PDF |
|
COW |
1.0 |
COVID-19 Questionnaire Wave 3 |
07/14/2023 |
PDF |
PDF |
