SPIROMICS Data Collection Forms and QxQs (Current)

Code Version Titlesort descending Date Form QxQ
HIQ 2.0 Home Information Questionnaire 03/12/2018 PDF icon PDF PDF icon PDF
AES 2.0 Adverse Events Form 01/09/2020 PDF icon PDF PDF icon PDF
ANT 2.0 Anthropometry Form 02/13/2018 PDF icon PDF PDF icon PDF
BIO 4.0 Biospecimen Collection Form 05/22/2018 PDF icon PDF PDF icon PDF
BPF 3.0 Blood Pressure Form 11/05/2018 PDF icon PDF PDF icon PDF
CBC 3.0 CBC Results Form 04/02/2019 PDF icon PDF PDF icon PDF
CSF 1.0 Clinically Significant Findings Form 11/12/2018 PDF icon PDF PDF icon PDF
CIF 3.0 Contact Information Form 01/31/2018 PDF icon PDF PDF icon PDF
CAT 2.0 COPD Assessment Test 11/03/2017 PDF icon PDF PDF icon PDF
COV 1.0 COVID-19 Questionnaire Wave 1 05/28/2020 PDF icon PDF PDF icon PDF
CVQ 1.0 COVID-19 Vaccine Questionnaire 07/29/2021 PDF icon PDF PDF icon PDF
DEM 4.0 Demographic Information Form 10/23/2017 PDF icon PDF PDF icon PDF
ECF 3.0 e-Cigarette Use Assessment for Follow-Up Form 09/24/2019 PDF icon PDF PDF icon PDF
EHA 2.0 Employment History Form for Follow-Up 12/18/2017 PDF icon PDF PDF icon PDF
EBC 1.0 Exhaled Breath Condensate Collection Form 06/11/2019 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
FUQ 4.0 Follow-Up Phone Questionnaire 07/28/2022 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
HBC 1.0 Hair and Buccal Collection Form 03/05/2019 PDF icon PDF PDF icon PDF
HGS 1.0 Hand Grip Strength Form 09/20/2017 PDF icon PDF PDF icon PDF
HDS 2.0 Hospital Anxiety and Depression Scale 10/09/2017 PDF icon PDF PDF icon PDF
CTF 3.0 Image Acquisition Form for Follow-Up 11/12/2018 PDF icon PDF PDF icon PDF
ISP 5.0 Induced Sputum Worksheet 09/24/2019 PDF icon PDF PDF icon PDF
ISW 5.0 Induced Sputum Worksheet 09/24/2019 PDF icon PDF PDF icon PDF
ITF 4.0 Informed Consent Tracking Form 05/28/2020 PDF icon PDF PDF icon PDF
LAB 2.0 Lab ID Form 12/13/2017 PDF icon PDF PDF icon PDF
LYS 1.0 Lysate Lab ID Form 05/10/2018 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
MUC 1.0 Mucin Lab ID Form 06/11/2018 PDF icon PDF PDF icon PDF
NQT 1.0 Nutritionquest Tracking Form 04/29/2020 PDF icon PDF PDF icon PDF
NQS 1.0 Nutritonquest Questionnaire ID Form 03/05/2019 PDF icon PDF, PDF icon PDF, PDF icon PDF PDF icon PDF
OSC 1.0 Oscillometry Data Form 06/19/2019 PDF icon PDF PDF icon PDF
OSR 1.0 Oscillometry Reading Center Data Form 11/24/2020 PDF icon PDF PDF icon PDF
PAX 1.0 Paxgene Lab ID Form 05/09/2018 PDF icon PDF PDF icon PDF
PID 3.0 Personal Identifiers Form 01/09/2018 PDF icon PDF PDF icon PDF
PLI 2.0 Phantom Lab ID Form 06/13/2018 PDF icon PDF PDF icon PDF
PFE 1.0 Pulmonary Function Eligibility Form 11/15/2017 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
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
SFH 3.0 SF12 Health Survey 11/07/2017 PDF icon PDF PDF icon PDF
SPB 1.0 Short Physical Performance Battery 02/05/2018 PDF icon PDF PDF icon PDF
SMW 4.0 Six Minute Walk Test 11/19/2018 PDF icon PDF PDF icon PDF
SDF 2.0 Spirometry Data Form 10/09/2017 PDF icon PDF PDF icon PDF
SLY 1.0 Sputolysin Lab ID Form 06/14/2018 PDF icon PDF PDF icon PDF
SPW 6.0 Sputum Processing Worksheet 04/22/2019 PDF icon PDF PDF icon PDF
SPU 3.0 Sputum Slide Form 04/29/2021 PDF icon PDF PDF icon PDF
SLI 1.0 Sputum Slide Lab ID Form 05/10/2018 PDF icon PDF PDF icon PDF
SGR 3.0 St. George's Respiratory Questionnaire 10/24/2017 PDF icon PDF PDF icon PDF
SKF 1.0 Stool Kit ID Form 03/26/2019 PDF icon PDF PDF icon PDF
STL 1.0 Stool Sample Collection Form 12/12/2019 PDF icon PDF, PDF icon PDF PDF icon PDF
TEC 2.0 Temporary Exclusion Criteria Form 07/07/2020 PDF icon PDF PDF icon PDF
VSA 2.0 Veterans Specific Activity Questionnaire 12/14/2017 PDF icon PDF PDF icon PDF