SOURCE Data Collection Forms and QxQs (Current)

Codesort descending Version Title Date Form QxQ
AES 1.0 Adverse Events Form 02/24/2021 PDF icon PDF PDF icon PDF
ANT 1.0 Anthropometry Form 02/24/2021 PDF icon PDF PDF icon PDF
BEQ 1.0 Baseline Exacerbation Questionnaire 02/24/2021 PDF icon PDF PDF icon PDF
BIO 1.0 Biospecimen Collection Form 06/24/2021 PDF icon PDF PDF icon PDF
BPF 1.0 Blood Pressure Form 06/10/2021 PDF icon PDF PDF icon PDF
CAA 1.0 Chronic Airway Assessment Test (CAAT) 06/03/2021 PDF icon PDF PDF icon PDF
CAP 1.0 COPD Assessment in Primary Care to Identify Undiagnosed Respiratory Disease and Exacerbation Risk (CAPTURE) 02/24/2021 PDF icon PDF PDF icon PDF
CBC 1.0 CBC Results Form 02/24/2021 PDF icon PDF PDF icon PDF
CIF 1.0 Contact Information Form 03/03/2021 PDF icon PDF PDF icon PDF
COQ 1.0 COVID-19 History Questionnaire 05/27/2021 PDF icon PDF PDF icon PDF
CSF 1.0 Clinically Significant Findings Form 04/07/2021 PDF icon PDF PDF icon PDF
CTA 1.0 CT Image Acquisition Form 02/24/2021 PDF icon PDF PDF icon PDF
DEM 1.0 Demographic Information Form 06/24/2021 PDF icon PDF PDF icon PDF
DNA 1.0 DNA PAXgene Label ID Form 03/08/2021 PDF icon PDF PDF icon PDF
EBC 1.0 Exhaled Breath Condensate Collection Form 02/24/2021 PDF icon PDF PDF icon PDF
ECA 1.0 Baseline E-Cigarette Use Assessment 04/23/2021 PDF icon PDF PDF icon PDF
EHB 1.0 Baseline Employment History Form 06/09/2021 PDF icon PDF PDF icon PDF
ELH 1.0 Early Life History Questionnaire 06/08/2021 PDF icon PDF PDF icon PDF
HDS 1.0 Hospital Anxiety and Depression Scale (HADS) 11/11/2021 PDF icon PDF PDF icon PDF
HIQ 1.0 Baseline Home Information Questionnaire 02/25/2021 PDF icon PDF PDF icon PDF
IEC 2.0 Inclusion/Exclusion Criteria Form 11/01/2021 PDF icon PDF PDF icon PDF
ISP 1.0 Induced Sputum Worksheet 11/01/2021 PDF icon PDF PDF icon PDF
ISW 1.0 Induced Sputum Worksheet 10/18/2021 PDF icon PDF PDF icon PDF
ITF 2.0 Informed Consent Tracking Form 09/09/2021 PDF icon PDF PDF icon PDF
LAB 1.0 Biospecimen Label ID Form 02/24/2021 PDF icon PDF PDF icon PDF
MED 1.0 Baseline Medication Use Questionnaire 06/24/2021 PDF icon PDF PDF icon PDF
MHB 1.0 Baseline Medical History Form 02/25/2021 PDF icon PDF PDF icon PDF
MRC 1.0 Modified Medical Research Council Dyspnea Scale 02/24/2021 PDF icon PDF PDF icon PDF
MUC 1.0 Mucin Label ID Form 03/08/2021 PDF icon PDF PDF icon PDF
NQS 1.0 NutritonQuest Questionnaire Label ID Form 03/23/2021 PDF icon PDF PDF icon PDF
NQT 1.0 NutritionQuest Tracking Form 03/23/2021 PDF icon PDF PDF icon PDF
NSB 1.0 Nasal Swab Label ID Form 10/07/2021 PDF icon PDF PDF icon PDF
OSC 1.0 Oscillometry Data Form 04/29/2021 PDF icon PDF PDF icon PDF
OSR 1.0 Oscillometry Reading Center Data Form 02/25/2021 PDF icon PDF PDF icon PDF
PFE 1.0 Pulmonary Function Eligibility Form 02/24/2021 PDF icon PDF PDF icon PDF
PID 1.0 Personal Identifiers Form 02/24/2021 PDF icon PDF PDF icon PDF
RDS 1.0 Baseline Respiratory Disease and Smoke Exposure Questionnaire 06/08/2021 PDF icon PDF PDF icon PDF
RNA 1.0 RNA PAXgene Label ID Form 03/08/2021 PDF icon PDF PDF icon PDF
RSW 1.0 Reason for Study Withdrawal Form 02/24/2021 PDF icon PDF PDF icon PDF
SDF 1.0 Spirometry Data Form 05/13/2021 PDF icon PDF PDF icon PDF
SGR 1.0 St. George's Respiratory Questionnaire 05/18/2021 PDF icon PDF PDF icon PDF
SKF 1.0 Stool Kit Label ID Form 02/24/2021 PDF icon PDF PDF icon PDF
SLI 1.0 Sputum Slide Label ID Form 03/08/2021 PDF icon PDF PDF icon PDF
SLY 1.0 Sputolysin Label ID Form 03/08/2021 PDF icon PDF PDF icon PDF
SPU 1.0 Sputum Slide Form 07/02/2021 PDF icon PDF PDF icon PDF
SPW 1.0 Sputum Processing Worksheet 11/23/2021 PDF icon PDF PDF icon PDF
STL 1.0 Stool Sample Collection Form 02/24/2021 PDF icon PDF PDF icon PDF