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BASELINE |
PRE-VISIT 9 |
VISIT 9 |
VISIT 10 |
VISIT 11 |
VISIT 12 |
VISIT 13 |
VISIT 14 |
VISIT 15 |
VISIT 16 |
VISIT 17 |
VISIT 18 |
VISIT 19 |
VISIT 20 |
VISIT 21 |
FOLLOW-UP
INTERVIEW/EXAM FORMS |
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Form# |
Title |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
DRUG1 |
Antiretroviral Medications |
na |
na |
na |
na |
10/1/1998 |
10/1/98 |
4/1/99 |
4/1/1999 |
10/1/1999a |
10/1/1999 |
4/1/2000a |
4/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000a |
10/1/2000a |
10/1/2001 |
10/1/2001 |
10/1/2001a |
10/1/2001a |
10/1/2002a |
10/1/2002 |
4/1/2003 |
4/1/2003 |
4/1/2003a |
4/1/2003a |
4/1/2004 |
4/1/2004 |
10/1/2004 |
10/1/2004 |
DRUG2 |
Non-antiviral Medications |
na |
na |
na |
na |
10/1/98 |
10/1/98 |
4/1/99 |
4/1/99 |
4/1/1999a |
4/1/1999a |
4/1/1999b |
4/1/1999b |
10/1/2000a |
10/1/2000 |
10/1/2000b |
10/1/2000b |
10/1/2000b |
10/1/2000b |
10/1/2000b |
10/1/2000b |
10/1/2000b |
10/1/2000b |
10/1/2000c |
10/1/2000c |
10/1/2003 |
10/1/2003 |
4/1/2004 |
4/1/2004 |
10/1/2004 |
10/1/2004 |
DRUG3 |
Hepatitis Medications |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2002a |
10/1/2002 |
4/1/2003a |
4/1/2003 |
4/1/2003b |
4/1/2003b |
4/1/2004a |
4/1/2004 |
10/1/2004 |
10/1/2004 |
F07 |
Physical Exam |
8/15/1994 |
8/15/1994 |
8/15/1994c |
4/1/1995 |
10/1/1998 |
10/1/1998a |
4/1/1999a |
4/1/1999a |
10/1/1999 |
10/1/1999 |
10/1/1999b |
10/1/1999 |
10/1/1999b |
10/1/1999b |
4/1/2001a |
4/1/2000 |
10/1/2001 |
10/1/2001 |
10/1/2001 |
10/1/2001 |
10/1/2002 |
10/1/2002a |
4/1/2003 |
4/1/2003 |
10/1/2003 |
10/1/2003 |
10/1/2003b |
10/1/2003b |
10/1/2004 |
10/1/2004 |
F08 |
Gynecological Exam |
8/15/1994 |
8/15/1994 |
4/1/1995d |
4/1/1995 |
10/1/1998 |
10/1/1998 |
4/1/1999a |
4/1/1999a |
10/1/99 |
10/1/1999 |
4/1/2000 |
4/1/2000 |
4/1/2000 |
4/1/2000 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
10/1/2004 |
10/1/2004 |
F08a |
Potential CVL Contaminants |
10/15/1995 |
na |
10/15/1995 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
F01*/F21 |
Sociodemographics |
8/15/1994c |
8/15/1994 |
4/1/1995 |
4/1/1995 |
10/1/98 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998a |
10/1/1998a |
10/1/1998b |
10/1/1998b |
10/1/1998b |
10/1/1998b |
10/1/1998b |
10/1/1998b |
10/1/1998b |
10/1/1998b |
4/1/2002 |
4/1/2002 |
10/1/2002 |
10/1/2002 |
10/1/2002 |
10/1/2002 |
10/1/2002 |
10/1/2002 |
10/1/2002 |
10/1/2002 |
10/1/2002 |
10/1/2002 |
F02*/F22* |
Medical & Health History |
8/15/1994c |
8/15/1994 |
8/15/1996 |
9/15/1997 |
10/1/1998b |
10/1/1998 |
4/1/1999b |
4/1/1999b |
10/1/1999a |
10/1/1999a |
4/1/2000a |
4/1/2000 |
10/1/2000 |
10/1/2000 |
4/1/2001a |
4/1/2001 |
10/1/2001 |
10/1/2001 |
10/1/2001b |
10/1/2001b |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
F22HX |
Follow-up Health History |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2002a |
10/1/2002 |
4/1/2003a |
4/1/2003 |
10/1/2003a |
10/1/2003 |
4/1/2004 |
4/1/2004 |
10/1/2004 |
10/1/2004 |
F22MED |
Medication History |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2002 |
10/1/2002a |
4/1/2003a |
4/1/2003 |
10/1/2003 |
10/1/2003 |
4/1/2004 |
4/1/2004 |
10/1/2004a |
10/1/2004 |
F03*/F23 |
OB/GYN History |
10/15/1994 |
8/15/1994 |
3/1/1996 |
8/1/1995 |
10/1/1998a |
10/1/1998 |
10/1/1998c |
10/1/1998c |
10/1/1999 |
10/1/1999 |
4/1/2000 |
4/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000a |
10/1/2000a |
10/1/2000a |
10/1/2000a |
10/1/2002 |
10/1/2002 |
4/1/2003b |
4/1/2003 |
10/1/2003 |
10/1/2003 |
4/1/2004a |
4/1/2004 |
10/1/2004 |
10/1/2004 |
F23a* |
Fertility and Infertility History |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2001a |
4/1/2001a |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
F04*/F24 |
Alcohol, Drugs & Sexual
Behavior |
8/15/1994c |
8/15/1994 |
6/1/1997 |
6/15/1997 |
10/1/1998a |
10/1/1998 |
4/1/1999 |
4/1/1999 |
10/1/1999a |
10/1/1999a |
4/1/2000a |
4/1/2000a |
4/1/2000a |
4/1/2000a |
4/1/2000a |
4/1/2000a |
10/1/2001a |
10/1/2001a |
10/1/2001a |
10/1/2001a |
10/1/2002 |
10/1/2002 |
4/1/2003 |
4/1/2003 |
10/1/2003a |
10/1/2003 |
4/1/2004 |
4/1/2004 |
10/1/2004 |
10/1/2004 |
F05*/F25 |
Health Care Utilization |
8/15/1994c |
8/15/1994 |
4/1/1995 |
9/15/1997 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
4/1/2004 |
4/1/2004 |
10/1/2004 |
10/1/2004 |
F25a* |
Health Care Utilization
Supplement |
na |
na |
8/1/1995 |
9/15/1997 |
10/1/1998a |
10/1/1998 |
na |
na |
10/1/1998a |
10/1/1998 |
na |
na |
10/1/1998a |
10/1/1998a |
na |
na |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
F06*/F26 |
Psychosocial |
10/15/1994d |
8/15/1994 |
4/1/1995 |
4/1/1995 |
10/1/98 |
10/1/98 |
10/1/1998b |
10/1/1998b |
na |
na |
10/1/1998c |
10/1/1998b |
na |
na |
10/1/1998d |
10/1/1998d |
10/1/1998d |
10/1/1998d |
10/1/1998d |
10/1/1998d |
10/1/1998d |
10/1/1998d |
10/1/1998d |
10/1/1998d |
10/1/2003 |
10/1/2003 |
10/1/2003 |
10/1/2003 |
10/1/2003 |
10/1/2003 |
FHX* |
Family and Personal History |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2001 |
10/1/2001 |
10/1/2001b |
10/1/2001b |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
*Discontinued |
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SPECIMEN
COLLECTION FORMS |
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Form# |
Title |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
F10 |
Plasma & Cell Separation and Freezing |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
8/15/1994 |
F09*/F29 |
Blood Specimen Collection Form |
8/15/1994c |
na |
3/1/1996 |
3/1/1996 |
3/1/96 |
3/1/1996 |
3/1/1996 |
3/1/1996 |
3/1/1996a |
3/1/1996 |
4/1/2000 |
4/1/2000 |
10/1/2000 |
10/1/2000 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/1/2001 |
4/2/2004 |
4/2/2004 |
4/2/2004a |
4/2/2004a |
F29a |
Antiviral Usage Assessment for
Blood Draw |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/1999a |
10/1/1999 |
10/1/1999b |
10/1/1999b |
10/1/2000 |
10/1/2000 |
10/1/2000a |
10/1/2000a |
10/1/2001 |
10/1/2001 |
10/1/2001a |
10/1/2001 |
10/1/2002 |
10/1/2002 |
4/1/2003 |
4/1/2003 |
4/1/2003a |
4/1/2003a |
4/1/2004 |
4/1/2004 |
10/1/2004 |
10/1/2004 |
F11*/F31 |
Specimens Collected During PE |
8/15/1994c |
na |
8/1/1995 |
8/1/1995 |
8/1/1995 |
8/1/1995 |
4/1/1999 |
4/1/1999 |
10/1/1999 |
10/1/1999 |
4/1/2000 |
4/1/2000 |
4/1/2000 |
4/1/2000 |
4/1/2000 |
4/1/2000 |
4/1/2000 |
4/1/2000 |
4/1/2000 |
4/1/2000 |
10/1/2002 |
10/1/2002 |
4/1/2003 |
4/1/2003 |
4/1/2003 |
4/1/2003 |
4/1/2004 |
4/1/2004 |
10/1/2004 |
10/1/2004 |
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LOCAL LAB FORMS |
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Form# |
Title |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
L01 |
HIV ELISA and Western Blot |
8/15/1994 |
na |
8/15/1994 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
L02* |
Serum Antibody Tests - Hepatitis |
8/15/1994 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
8/15/1994 |
na |
8/15/1994 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
L03 |
Automated CBC/Differential |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/94 |
na |
8/15/1994 |
na |
8/15/1994a |
na |
8/15/1994a |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2004 |
na |
L03a |
Hand-Manual Differential |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2004 |
na |
L04 |
Flow Cytometry |
8/15/1994 |
na |
8/15/1994 |
na |
10/1/98 |
na |
10/1/1998a |
na |
10/1/1998b |
na |
10/1/1998b |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2004 |
na |
L05 |
Liver/Renal Function Tests |
8/15/1994c |
na |
8/15/1994c |
na |
8/15/1994c |
na |
na |
na |
8/15/1994c |
na |
na |
na |
8/15/1994c |
na |
8/15/1994c |
na |
8/15/1994c |
na |
4/1/2002 |
na |
10/1/2002 |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003 |
na |
L06* |
Serum Antibody Tests - Syphilis
Screening |
8/15/1994c |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2001 |
na |
10/1/2001 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
L07* |
Mantoux Skin Test Result Anergy
Panel |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/94 |
na |
na |
na |
10/1/1999 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
L08* |
PPD Skin Test |
1/15/1995 |
na |
1/15/1995 |
na |
1/15/1995 |
na |
na |
na |
10/1/1999 |
na |
na |
na |
10/1/1999 |
na |
na |
na |
10/1/1999 |
na |
10/1/1999 |
na |
10/1/1999 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
L09* |
Chlamydia |
8/15/1994 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2002 |
na |
10/1/2002 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
L10* |
Urinalysis |
8/15/1994c |
na |
8/15/1994c |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
L11* |
Urine Culture Results |
8/15/1994 |
na |
8/15/1994 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
8/15/1994 |
na |
8/15/1994 |
na |
na |
na |
na |
na |
na |
na |
L12 |
(Urine) Pregnancy Test |
8/15/1994d |
na |
8/15/1994d |
na |
8/15/1994d |
na |
8/15/1994d |
na |
8/15/1994d |
na |
8/15/1994d |
na |
8/15/1994d |
na |
8/15/1994d |
na |
8/15/1994d |
na |
8/15/1994d |
na |
8/15/1994d |
na |
8/15/1994d |
na |
8/15/1994d |
na |
8/15/1994d |
na |
8/15/1994d |
na |
L13* |
Gonorrhea |
8/15/1994 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2002 |
na |
10/1/2002 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
L14 |
Colposcopy Results |
9/15/1995 |
9/15/1997 |
9/15/1995 |
9/15/1997 |
9/15/95 |
9/15/1997 |
9/15/1995 |
9/15/1997 |
9/15/1995 |
9/15/1997 |
4/1/2000 |
4/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2002 |
10/1/2002 |
10/1/2002a |
10/1/2002a |
10/1/2002a |
10/1/2002a |
10/1/2002a |
10/1/2002a |
10/1/2002a |
10/1/2002a |
L15 |
Biopsy Histopathology Pelvic Exam |
9/15/1995 |
9/15/1997 |
9/15/1995 |
9/15/1997 |
9/15/95 |
9/15/1997 |
4/1/1999a |
4/1/1999 |
4/1/1999a |
4/1/1999 |
4/1/1999a |
4/1/1999 |
4/1/1999a |
4/1/1999 |
4/1/1999a |
4/1/1999 |
4/1/1999a |
4/1/1999 |
4/1/199a |
4/1/1999 |
10/1/2002 |
10/1/2002 |
4/1/2003 |
4/1/2003 |
4/1/2003 |
4/1/2003 |
4/1/2003 |
4/1/2003 |
4/1/2003 |
4/1/2003 |
L16 |
Dysplasia Treatment |
5/1/1995 |
9/15/1997 |
5/1/1995 |
9/15/1997 |
5/1/1995 |
9/15/1997 |
5/1/1995 |
9/15/1997 |
5/1/1995 |
9/15/1997 |
5/1/1995 |
9/15/1997 |
5/1/1995 |
9/15/1997 |
5/1/1995 |
9/15/1997 |
5/1/1995 |
9/15/1997 |
5/1/1995 |
9/15/1997 |
5/1/1995 |
9/15/1997 |
5/1/1995 |
9/15/1997 |
5/1/1995 |
9/15/1997 |
5/1/1995 |
9/15/1997 |
5/1/1995 |
9/15/1997 |
L17* |
Herpes Culture of Ulcers and
Fissures |
10/15/1994d |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/15/1994d |
na |
10/15/1994d |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
L18 |
Trichomonas Vaginalis Culture
(optional) |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
L19 |
CVL Processing |
8/25/1997 |
na |
8/25/1997 |
na |
10/1/98 |
na |
10/1/1998 |
na |
10/1/1999 |
na |
10/1/1999 |
na |
10/1/1999 |
na |
10/1/1999 |
na |
10/1/2001 |
na |
10/1/2001 |
na |
10/1/2001 |
na |
10/1/2001 |
na |
10/1/2001 |
na |
10/1/2001 |
na |
10/1/2001 |
na |
*Discontinued |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
CENTRAL LAB
FORMS |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Form# |
Title |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
C30* |
Toxoplasma Serology |
8/15/1994 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
C31* |
Human Retrovirus Testing |
4/1/1995c |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/1995c |
na |
4/1/1995c |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
C45 |
Bacterial Vaginosis Smear Gram
Stain |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
C50* |
Urine for Chlamydia |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
na |
na |
8/15/1994 |
na |
na |
na |
8/15/1994 |
na |
na |
na |
8/15/1994 |
na |
8/15/1994 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
C52 |
HPV by PCR |
8/1/1995 |
na |
8/1/1995 |
na |
8/1/1995 |
na |
8/1/1995 |
na |
8/1/1995 |
na |
8/1/1995 |
na |
8/1/1995 |
na |
8/1/1995 |
na |
8/1/1995 |
na |
8/1/1995 |
na |
8/1/1995 |
na |
8/1/1995 |
na |
8/1/1995 |
na |
8/1/1995 |
na |
8/1/1995 |
na |
C54 |
Viral Load |
12/16/1996 |
na |
12/16/1996 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
4/1/2000 |
na |
4/1/2000 |
na |
4/1/2000 |
na |
4/1/2000 |
na |
4/1/2000 |
na |
4/1/2000 |
na |
4/1/2000 |
na |
4/1/2000 |
na |
4/1/2000 |
na |
4/1/2000 |
na |
C60 |
Pap Smear |
8/15/1994 |
na |
8/15/1994 |
na |
10/1/1998 |
na |
4/1/1999 |
na |
4/1/1999 |
na |
4/1/1999 |
na |
4/1/1999 |
na |
4/1/1999 |
na |
4/1/1999 |
na |
4/1/2002 |
na |
4/1/2002 |
na |
4/1/2002 |
na |
4/1/2002 |
na |
4/1/2002 |
na |
4/1/2002 |
na |
C60a |
Pap Smear Retrospective Re-Read
v1-15 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003 |
na |
C60b |
Pap Smear Retrospective Re-Read
v16 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003 |
na |
C65 |
Syphilis DFA - Genital Ulcers
& Fissure |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
8/15/1994 |
na |
C66* |
Serum Antibody Type-Specific
Herpes Serology |
1/6/1997 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
1/6/1997 |
na |
1/6/1997 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
C70 |
Laboratory - Stimulated Saliva
Evaluation |
10/15/1996 |
na |
10/15/1996 |
na |
10/15/96 |
na |
10/15/1996 |
na |
10/15/1996 |
na |
10/15/1996a |
na |
10/15/1996a |
na |
10/15/1996a |
na |
10/15/1996a |
na |
10/15/1996a |
na |
10/15/1996a |
na |
10/15/1996a |
na |
10/15/1996a |
na |
10/15/1996a |
na |
10/15/1996a |
na |
C71 |
Laboratory - Subgingival Plaque |
10/15/1996 |
na |
10/15/1996 |
na |
10/15/1996 |
na |
4/1/1999 |
na |
4/1/1999 |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
C72 |
Laboratory - Erythematous Candidiasis Smear Results |
na |
na |
na |
na |
na |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
*Discontinued |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|
|
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|
|
|
|
|
|
|
ADMINISTRATIVE
FORMS |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Form# |
Title |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
ABRV |
Abbreviated Visit |
na |
na |
8/1/1997 |
na |
8/1/97 |
na |
8/1/1997 |
na |
8/1/1997 |
na |
4/1/2000 |
na |
4/1/2000 |
na |
4/1/2000 |
na |
10/1/2001 |
na |
10/1/2001 |
na |
10/1/2001 |
na |
10/1/2001a |
na |
10/1/2001a |
na |
10/1/2001a |
na |
10/1/2001a |
na |
ANTHRO |
Anthropometry Training Form |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2002 |
na |
10/1/2002a |
na |
10/1/2002a |
na |
10/1/2002a |
na |
10/1/2002a |
na |
DENR |
Disenrollment Form |
na |
na |
6/15/1997 |
11/1/1997 |
10/1/98 |
10/1/98 |
4/1/1999b |
4/1/1999b |
4/1/1999b |
4/1/1999b |
4/1/1999c |
4/1/1999c |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
4/1/2003 |
10/1/2002 |
4/1/2003 |
10/1/2002 |
4/1/2004 |
4/1/2004 |
4/1/2004 |
4/1/2004 |
INT* |
Interim Events Form |
na |
na |
na |
na |
na |
na |
4/1/1999 |
na |
10/1/1999 |
na |
10/1/1999 |
na |
10/1/2000 |
na |
10/1/2000a |
na |
10/1/2000a |
na |
10/1/2000a |
na |
10/1/2000b |
na |
10/1/2000b |
na |
10/1/2000b |
na |
10/1/2000b |
na |
na |
na |
MVIS |
Missed Visit Form |
na |
na |
8/1/1996 |
8/1/1996c |
10/1/98 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
REF |
Referral Checklist |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2000 |
na |
4/1/2000 |
na |
4/1/2000 |
na |
10/1/2001 |
na |
4/1/2002 |
na |
4/1/2002 |
na |
4/1/2003 |
na |
10/1/2003 |
na |
10/1/2003 |
na |
10/1/2004 |
na |
TRAN |
Transfer Form |
na |
na |
9/1/1995 |
na |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/2001 |
10/1/2001 |
10/1/2001 |
10/1/2001 |
10/1/2001 |
10/1/2001 |
10/1/2001a |
10/1/2001a |
10/1/2001a |
10/1/2001a |
10/1/2001a |
10/1/2001a |
10/1/2001a |
10/1/2001a |
*Discontinued |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
OUTCOMES
ASCERTAINMENT FORMS |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Form# |
Title |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
ACS* |
Ascertainment Control Sheet |
na |
na |
na |
na |
na |
10/1/1998 |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999b |
na |
4/1/1999c |
na |
4/1/1999c |
na |
4/1/1999c |
na |
4/1/1999c |
na |
4/1/1999c |
na |
4/1/1999c |
na |
4/1/1999c |
na |
na |
na |
na |
ATC |
Ascertainment Tracking Checklist |
8/15/1994c |
9/15/1997 |
2/1/1997 |
9/15/1997 |
10/1/98 |
10/1/98 |
10/1/98 |
10/1/1998 |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/98a |
4/1/2004 |
10/1/1998a |
4/1/2004 |
CNCR |
Cancer Registry Case Report |
na |
na |
na |
na |
na |
na |
5/20/1999 |
5/20/1999 |
5/20/1999 |
5/20/1999 |
5/20/1999 |
5/20/1999 |
5/20/1999 |
5/20/1999 |
5/20/1999a |
5/20/1999a |
5/20/1999a |
5/20/1999a |
5/20/1999a |
5/20/1999a |
5/20/1999a |
5/20/1999a |
5/20/1999a |
5/20/1999a |
5/20/1999a |
5/20/1999a |
5/20/1999b |
5/20/1999b |
5/20/1999b |
5/20/1999b |
CORE |
Clinical Outcomes Reporting Form |
na |
na |
na |
na |
na |
na |
4/1/1999b |
4/1/1999a |
4/1/1999b |
4/1/1999d |
4/1/1999c |
4/1/1999e |
10/1/2000 |
10/1/2000 |
4/1/2001 |
4/1/2001a |
4/1/2001 |
4/1/2001a |
4/1/2001a |
4/1/2001a |
4/1/2001a |
4/1/2001a |
4/1/2003 |
4/1/2003 |
4/1/2003 |
4/1/2003 |
4/1/2003 |
4/1/2003 |
10/1/2004 |
10/1/2004 |
TB |
TB - Verified Case Report |
na |
na |
na |
na |
na |
na |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
1/12/1999 |
*Discontinued |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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ACSR PROTOCOL
FORMS |
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Form# |
Title |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
ACSR ATC |
ACSR Ascertainment Tracking Checklist |
na |
na |
na |
na |
na |
na |
4/1/1999 |
na |
4/1/1999 |
na |
4/1/1999 |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999a |
na |
4/1/1999b |
na |
4/1/1999b |
na |
4/1/1999b |
na |
4/1/1999b |
na |
QCCD |
QC Review of Cancer Diagnoses |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2004 |
4/1/2004 |
4/1/2004 |
4/1/2004 |
QCGY |
QC Review of Gynecologic Material |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
QCSS |
QC Central Review of Surgical
Specimens |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
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CARDIOVASCULAR
SUBSTUDY FORMS |
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Form# |
Title |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
CVNOTI |
Participant Notification |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2004a |
4/1/2004a |
4/1/2004a |
4/1/2004a |
CV01 |
Carotid Ultrasound Tracking Form |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2004b |
4/1/2004 |
10/1/2004 |
10/1/2004 |
CV29 |
Fasting Blood Specimen Collection Form |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/2/2004 |
4/2/2004 |
10/14/2004 |
10/14/2004 |
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HHV-8 SUBSTUDY
FORMS |
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Form# |
Title |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
HVDENR |
Disenrollment |
na |
na |
na |
na |
na |
na |
4/1/1999 |
na |
4/1/1999 |
na |
4/1/1999 |
na |
na |
na |
na |
na |
4/1/1999 |
na |
4/1/1999 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
HVMVIS |
Missed Visit |
na |
na |
na |
na |
na |
na |
4/1/1999 |
na |
4/1/1999 |
na |
4/1/1999 |
na |
na |
na |
na |
na |
4/1/1999 |
na |
4/1/1999 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
HVNOTI |
Recruitment Outcome Form |
na |
na |
na |
na |
na |
na |
4/1/1999 |
na |
4/1/1999 |
na |
4/1/1999 |
na |
na |
na |
na |
na |
4/1/1999 |
na |
4/1/1999 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
HVSPEC |
Specimen Collection |
na |
na |
na |
na |
na |
na |
4/1/1999 |
na |
4/1/1999 |
na |
4/1/1999 |
na |
na |
na |
na |
na |
4/1/1999 |
na |
4/1/1999 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
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INTENSIVE PK
SUBSTUDY FORMS |
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Form# |
Title |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
PK01 |
Eligibility for Intensive PK Stubstudy |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2004 |
na |
4/1/2004 |
na |
PKNOTI |
PK: Participant notification |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2004 |
na |
4/1/2004 |
na |
PK02 |
PK: Current Antiretroviral
medication use |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
4/1/2003a |
na |
4/1/2003b |
na |
10/1/2004 |
na |
PK02a |
PK: Antiretroviral adherence |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003a |
na |
4/1/2003a |
na |
PK03 |
PK: Recent illnesses, concurrent
meds & OB/GYN hist |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003a |
na |
4/1/2003a |
na |
4/1/2003a |
na |
4/1/2003a |
na |
PK04 |
PK: Recent substance use |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003 |
na |
PK05a |
PK: Weight
and Specimen collection: group A |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003a |
na |
4/1/2003a |
na |
4/1/2003a |
na |
4/1/2003a |
na |
PK05b |
PK: Weight and Specimen
collection: group B |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2004 |
na |
4/1/2004 |
na |
PK05c |
PK: Weight and Specimen
collection: group C |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003a |
na |
4/1/2003a |
na |
4/1/2004 |
na |
4/1/2004 |
na |
PK06 |
PK: Dosing of antiretroviral
medications |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
10/6/2003 |
na |
10/6/2003b |
na |
10/1/2004 |
na |
PK07 |
PK: Plasma Separation and
Freezing Form |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003 |
na |
PK08 |
PK: Dietary Fat Percentage
Questionnaire |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
5/14/2003 |
na |
5/14/2003a |
na |
5/14/2003a |
na |
5/14/2003a |
na |
PK-DIET |
PK: Dietary Assessment |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003a |
na |
4/1/2003a |
na |
4/1/2003a |
na |
4/1/2003a |
na |
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NEUROCOGNITION
SUBSTUDY FORMS |
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Form# |
Title |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
NC01a |
Cognitive Measures (Standard TMT and SDMT) |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2004b |
10/1/2004b |
NC01a |
Interviewer Script |
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|
10/1/2004 |
na |
NC01b |
Cognitive Measures (Color TMT) |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2004b |
10/1/2004b |
NC01b |
Interviewer Script |
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|
10/1/2004 |
na |
NC02a |
English Word List (WRAT) |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2004b |
10/1/2004b |
NC03 |
Educational Experience |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2004 |
10/1/2004 |
NC04 |
Wechsler Test of Adult Reading (WTAR) |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
NC05 |
Interviewer Feedback |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/11/2004 |
10/11/2004 |
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|
NIDA I/V AND
HCU |
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|
Form# |
Title |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
NI01* |
Health Care Utilization Collaborative WIHS/HERS Interview |
na |
na |
11/1/1996c |
11/1/1996c |
10/1/1998 |
10/1/1998 |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
NI02* |
General Abstraction |
na |
na |
9/15/1997 |
9/15/1997 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
NI03* |
Pneumonia Abstraction |
na |
na |
11/1/1996 |
11/1/1996 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
NI04* |
Pneumonia Episode Abstraction |
na |
na |
8/1/1997 |
8/1/1997 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
NI05* |
Diarrhea Abstraction |
na |
na |
11/1/1996c |
11/1/1996c |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
NVNOTI* |
Participant Notification |
na |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
NV01* |
Enrollment Interview |
na |
na |
11/15/1997 |
11/15/1997 |
11/15/1997 |
11/15/1997 |
11/15/1997 |
11/15/1997 |
11/15/1997 |
11/15/1997 |
11/15/1997 |
11/15/1997 |
11/15/1997 |
11/15/1997 |
11/15/1997 |
11/15/1997 |
11/15/1997 |
11/15/1997 |
11/15/1997 |
11/15/1997 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
NV02* |
Antiretroviral Drug Use |
na |
na |
11/15/1997 |
11/15/1997 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
NV03* |
Specimen Collection |
na |
na |
11/15/1997 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
NV04* |
Specimen Processing |
na |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
NV05* |
Flow Cytometry |
na |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
11/15/1997 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
NV06* |
RNA Quantification on CVL |
na |
na |
11/15/1997 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
NV07* |
Urine Toxicology |
na |
na |
11/15/1997 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
*Discontinued |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
ORAL PROTOCOL
FORMS |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|
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|
|
|
|
|
|
Form# |
Title |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
OPNOTI* |
Oral Protocol Participant Notification (expansion) |
3/1/1995 |
na |
3/1/1995 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2001 |
na |
10/1/2001 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
OP01* |
Medical Evaluation |
10/1/1995c |
9/1/1997 |
10/1/1995c |
9/1/1997 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
4/1/2004 |
10/1/1998a |
na |
na |
OP02* |
Research Interview |
3/1/1995 |
9/1/1997 |
3/1/1995 |
9/1/1997 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
4/1/2003 |
4/1/2003 |
10/1/2003 |
10/1/2003 |
10/1/2003 |
10/1/2003 |
na |
na |
OP03* |
Saliva Sample Collection |
9/1/1996 |
9/1/1997 |
9/1/1996 |
9/1/1997 |
10/1/1998 |
10/1/1998 |
4/1/1999 |
4/1/1999 |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
na |
na |
OP04* |
Oral Mucosal Tissue Exam |
3/1/1995 |
9/1/1997 |
3/1/1995 |
9/1/1997 |
10/1/98 |
10/1/1998 |
10/1/1998a |
10/1/1998a |
10/1/1998a |
10/1/1998a |
4/1/2000 |
4/1/2000 |
4/1/2000 |
4/1/2000 |
4/1/2000 |
4/1/2000 |
4/1/2000 |
4/1/2000 |
4/1/2000 |
4/1/2000 |
4/1/2000a |
4/1/2000 |
4/1/2000a |
4/1/2000 |
4/1/2000a |
4/1/2000 |
4/1/2000a |
4/1/2000a |
na |
na |
OP04a* |
Addendum |
3/1/1995 |
na |
3/1/1995 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998a |
na |
10/1/1998a |
na |
10/1/1998a |
na |
10/1/1998a |
na |
10/1/1998a |
na |
10/1/1998a |
na |
10/1/1998a |
na |
10/1/1998a |
na |
10/1/1998a |
na |
10/1/1998a |
na |
na |
na |
OP05* |
Smear Results |
3/1/1995 |
9/1/1997 |
3/1/1995 |
9/1/1997 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
na |
na |
OP06* |
Tooth Count & Random Half
Mouth |
3/1/1995c |
9/1/1997 |
3/1/1995c |
9/1/1997 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
na |
na |
OP07* |
Plaque Index |
3/1/1995 |
9/1/1997 |
3/1/1995 |
9/1/1997 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
na |
na |
OP08* |
Gingival Banding Score |
3/1/1995 |
9/1/1997 |
3/1/1995 |
9/1/1997 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
4/1/2003 |
4/1/2003 |
4/1/2003 |
4/1/2003 |
4/1/2003 |
4/1/2003 |
na |
na |
OP09* |
Papillary Assessment |
3/1/1995 |
9/1/1997 |
3/1/1995 |
9/1/1997 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
4/1/2003 |
4/1/2003 |
10/1/2003 |
10/1/2003 |
10/1/2003 |
10/1/2003 |
na |
na |
OP10* |
Subgingival Plaque |
7/1/1997 |
11/1/1997 |
7/1/1997 |
11/1/1997 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998a |
10/1/1998 |
10/1/1998a |
10/1/1998 |
10/1/1998a |
10/1/1998 |
10/1/1998a |
10/1/1998 |
10/1/1998a |
10/1/1998 |
10/1/1998a |
10/1/1998 |
10/1/1998a |
10/1/1998 |
10/1/1998a |
4/1/2003 |
4/1/2003 |
10/1/2003 |
10/1/2003 |
10/1/2003 |
10/1/2003 |
na |
na |
OP11* |
Coronal Caries |
3/1/1995 |
9/1/1997 |
3/1/1995 |
9/1/1997 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
na |
na |
OP12* |
Root Caries |
3/1/1995 |
9/1/1997 |
3/1/1995 |
9/1/1997 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
na |
na |
OP13* |
Gingival Bleeding |
3/1/1995 |
9/1/1997 |
3/1/1995 |
9/1/1997 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
na |
na |
OP14* |
Loss of Attachment |
3/1/1995 |
9/1/1997 |
3/1/1995 |
9/1/1997 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
10/1/1998 |
3/1/1995 |
4/1/2003 |
3/1/1995 |
4/1/2003 |
3/1/1995 |
4/1/2003 |
na |
na |
OP15* |
Dental Prostheses |
3/1/1995c |
9/1/1997 |
3/1/1995c |
9/1/1997 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
10/1/1998 |
na |
na |
OP16* |
Oral Referral and F/U |
3/1/1995c |
9/1/1997 |
3/1/1995c |
9/1/1997 |
10/1/1998 |
10/1/1998 |
4/1/1999 |
4/1/1999 |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
4/1/1999a |
na |
na |
*Discontinued |
|
|
|
|
|
|
|
|
|
|
|
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|
|
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|
|
PREGNANCY
PROTOCOL FORMS |
|
|
|
|
|
|
|
|
|
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|
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|
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|
|
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|
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|
|
|
|
|
|
|
|
Form# |
Title |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
PRNOTI |
Enrollment |
na |
na |
na |
na |
na |
na |
4/1/1999a |
na |
10/1/1999 |
na |
10/1/1999 |
na |
10/1/1999 |
na |
10/1/1999 |
na |
10/1/1999 |
na |
10/1/1999 |
na |
10/1/1999 |
na |
10/1/1999 |
na |
10/1/1999 |
na |
10/1/1999 |
na |
10/1/1999 |
na |
PR01 |
Pregnancy Form |
na |
na |
na |
na |
na |
na |
4/1/1999a |
4/1/1999a |
4/1/1999b |
4/1/1999b |
4/1/1999b |
4/1/1999b |
4/1/1999b |
4/1/1999b |
4/1/1999b |
4/1/1999b |
4/1/1999b |
4/1/1999b |
4/1/1999b |
4/1/1999b |
4/1/1999b |
4/1/1999b |
4/1/1999b |
4/1/1999c |
4/1/1999b |
4/1/1999c |
4/1/1999b |
4/1/1999b |
10/1/2004 |
10/1/2004 |
PR02 |
Post-partum Form |
na |
na |
na |
na |
na |
na |
4/1/1999a |
4/1/1999a |
4/1/1999c |
4/1/1999b |
4/1/1999d |
4/1/1999c |
4/1/1999d |
4/1/1999c |
4/1/1999d |
4/1/1999c |
4/1/1999d |
4/1/1999c |
4/1/1999d |
4/1/1999c |
4/1/1999d |
4/1/1999c |
4/1/1999d |
4/1/1999d |
10/1/2003 |
10/1/2003 |
10/1/2003 |
10/1/2003 |
10/1/2004 |
10/1/2004 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|
|
|
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|
|
|
|
|
|
PROSPECTIVE
METABOLIC SUBSTUDY FORMS |
|
|
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|
|
|
|
|
|
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|
|
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|
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|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Form# |
Title |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
MSSCR |
MS: Screening form |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003 |
na |
MSNOTI |
MS: Participant notification |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003a |
na |
4/1/2003a |
na |
MS01 |
MS: Specimen Collection for
Metabolic Study |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
6/13/2003 |
na |
6/13/2003a |
na |
6/11/2004 |
na |
6/11/2004a |
na |
MS02 |
MS: Lab test report form |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003 |
na |
MS03 |
MS: DXA scan form |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003 |
na |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
SEX STEROID
SUBSTUDY FORMS |
|
|
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|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Form# |
Title |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
SSSCR |
SS: Sex steroid screening form |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003a |
4/1/2003 |
4/1/2003a |
4/1/2003 |
4/1/2003b |
4/1/2003a |
4/1/2003b |
4/1/2003a |
SSNOTI |
SS: Participant notification |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003 |
na |
SS01 |
SS: Sex steroid lab test report
form |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
10/1/2003 |
na |
10/1/2003 |
na |
10/1/2003a |
na |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
VRS SUBSTUDY
FORMS |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|
|
|
|
|
|
|
|
Form# |
Title |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
VRSNOTI* |
VRS Enrollment Form |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2000 |
na |
10/1/2000 |
na |
na |
na |
na |
na |
na |
na |
10/1/2000 |
na |
10/1/2000 |
na |
na |
na |
na |
na |
VRS01 * |
Stage II Eligibility |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2000 |
10/1/2000 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
VRS01r* |
VRS Eligibility for VRS
Supplement |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
1/1/2002 |
1/1/2002 |
1/1/2002 |
1/1/2002 |
1/1/2002 |
1/1/2002 |
na |
na |
na |
na |
VRS03* |
VRS Illnesses and Medications |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2002 |
10/1/2002 |
10/1/2002 |
10/1/2002 |
10/1/2002 |
10/1/2002 |
na |
na |
na |
na |
VRS04* |
VRS Antiviral Medications |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2001a |
10/1/2001a |
10/1/2001a |
10/1/2001a |
10/1/2001a |
10/1/2001a |
1/1/2002c |
1/1/2002c |
10/1/2003 |
10/1/2003 |
na |
na |
na |
na |
VRS05* |
VRS Screening to Determine
Changes in HAART Regimen |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2000 |
10/1/2000 |
4/1/2001 |
4/1/2001 |
4/1/2001a |
4/1/2001a |
4/1/2001a |
4/1/2001a |
4/1/2001a |
4/1/2001a |
4/1/2003 |
4/1/2003 |
4/1/2003a |
10/1/2003 |
na |
na |
na |
na |
VRS06* |
VRS Telephone Interview for
Medical Providers |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2000 |
10/1/2000 |
10/1/2000b |
10/1/2000b |
10/1/2000b |
10/1/2000b |
10/1/2000b |
10/1/2000b |
10/1/2000b |
10/1/2000b |
10/1/2000b |
10/1/2000b |
10/1/2000b |
10/1/2000b |
na |
na |
na |
na |
VRS06r* |
VRS Telephone Interview for
Medical Providers |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
6/1/2002 |
6/1/2002 |
6/1/2002 |
6/1/2002 |
6/1/2002 |
6/1/2002 |
6/1/2002 |
6/1/2002 |
na |
na |
na |
na |
VRS10* |
VRS Plasma Separation and
Freezing |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
1/12/2000 |
1/12/2000 |
1/12/2000 |
1/12/2000 |
1/12/2000 |
1/12/2000 |
1/12/2000 |
1/12/2000 |
10/1/2002 |
1/10/2002 |
10/1/2002 |
10/1/2002 |
10/1/2003 |
10/1/2003 |
na |
na |
na |
na |
VRS29* |
VRS Blood Specimen Collection Form |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2000 |
10/1/2002 |
10/1/2002 |
4/1/2003 |
4/1/2003 |
10/1/2003 |
10/1/2003 |
na |
na |
na |
na |
*Discontinued |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
EXPANSION
FORMS |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Form# |
Title |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
EL* |
New Recruit Eligibility Form |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2001a |
10/1/2001 |
10/12001a |
10/1/2001 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
F07r* |
Physical Exam Addendum |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2001 |
10/1/2001 |
10/1/2001 |
10/1/2001 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
F20* |
New Recruit Baseline History |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2001 |
10/1/2001 |
4/1/2002 |
4/1/2002 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
F20a* |
New Recruit Baseline History:
Addendum |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
1/1/2002 |
1/1/2002 |
1/1/2002 |
1/1/2002 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
F22r* |
New
Recruit ART History |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2002a |
4/1/2002a |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
F29r* |
Blood Specimen Collection Form |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2001 |
na |
10/1/2001 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
F31r* |
Specimens Collected During PE |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2001a |
na |
10/1/2001a |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
RAB* |
Retrospective Medical Record
Abstraction |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2001a |
10/1/2001a |
10/1/2001a |
10/1/2001a |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
RAB App* |
Retrospective Medical Record
Abstraction Appendix |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2001a |
na |
10/1/2001a |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
S2* |
New
Recruit Sreening Form |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2001b |
10/1/2001b |
10/1/2001b |
10/1/2001b |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
*Discontinued |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
SPANISH
VERSIONS |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Form# |
Title |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
Form |
QxQ |
ABRV |
Abbreviated Visit |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2000 |
na |
4/1/2000 |
na |
4/1/2000 |
na |
10/1/2001 |
na |
10/1/2001 |
na |
10/1/2001 |
na |
10/1/2001a |
na |
10/1/2001a |
na |
10/1/2001a |
na |
10/1/2001a |
na |
CV01 |
Carotid Ultrasound Tracking Form |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2004b |
na |
10/1/2004 |
na |
CV29 |
Fasting Blood Specimen Collection
Form |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/2/2004 |
na |
10/14/2004 |
na |
DRUG1 |
Antiretroviral Medications |
na |
na |
na |
na |
10/1/1998a |
na |
4/1/1999 |
na |
10/1/1999 |
na |
4/1/2000a |
na |
10/1/2000 |
na |
10/1/2000a |
na |
10/1/2001 |
na |
10/1/2001a |
na |
10/1/2002a |
na |
4/1/2003 |
na |
4/1/2003a |
na |
4/1/2004 |
na |
10/1/2004 |
na |
DRUG2 |
Non-antiviral Medications |
na |
na |
na |
na |
10/1/1998 |
na |
4/1/1999 |
na |
4/1/1999a |
na |
4/1/1999b |
na |
10/1/2000a |
na |
10/1/2000b |
na |
10/1/2000b |
na |
10/1/2000b |
na |
10/1/2000b |
na |
10/1/2000c |
na |
10/1/2003 |
na |
4/1/2004 |
na |
10/1/2004 |
na |
DRUG3 |
Hepatitis Medications |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2002a |
na |
4/1/2003a |
na |
4/1/2003b |
na |
4/1/2004 |
na |
10/1/2004 |
na |
F07 |
Physical Exam |
na |
na |
na |
na |
na |
na |
4/1/1999a |
na |
10/1/1999 |
na |
10/1/1999b |
na |
10/1/1999b |
na |
4/1/2001a |
na |
10/1/2001 |
na |
10/1/2001 |
na |
10/1/2002 |
na |
4/1/2003 |
na |
10/1/2003 |
na |
10/1/2003b |
na |
10/1/2004 |
na |
F20* |
New Recruit Baseline History
(Spanish) |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2001 |
na |
4/1/2002 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
F20a* |
New Recruit Baseline History:
Addendum (Spanish) |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
1/1/2002 |
na |
1/1/2002 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
F01*/F21 |
Sociodemographics |
8/15/1994c |
na |
4/1/1995 |
na |
10/1/1998 |
na |
10/1/1998a |
na |
10/1/1998b |
na |
10/1/1998c |
na |
10/1/1998c |
na |
10/1/1998c |
na |
10/1/1998c |
na |
4/1/2002 |
na |
10/1/2002 |
na |
10/1/2002 |
na |
10/1/2002 |
na |
10/1/2002 |
na |
10/1/2002 |
na |
F02*/F22* |
Medical & Health History |
8/15/1994c |
na |
8/15/1996 |
na |
10/1/1998b |
na |
4/1/1999b |
na |
10/1/1999 |
na |
4/1/2000a |
na |
10/1/2000 |
na |
4/1/2001a |
na |
10/1/2001 |
na |
10/1/2001b |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
F22HX |
Follow-up Health History |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2002a |
na |
4/1/2003a |
na |
10/1/2003 |
na |
4/1/2004 |
na |
10/1/2004 |
na |
F22MED |
Medication History |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2002 |
na |
4/1/2003a |
na |
10/1/2003 |
na |
4/1/2004 |
na |
10/1/2004 |
na |
F22r * |
New
Recruit ART History |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2002a |
4/1/2002a |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
F03*/F23 |
OB/GYN History |
10/15/1994 |
na |
3/1/1996 |
na |
10/1/1998 |
na |
10/1/1998c |
na |
10/1/1999 |
na |
4/1/2000 |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2000a |
na |
10/1/2000a |
na |
10/1/2002 |
na |
4/1/2003a |
na |
10/1/2003 |
na |
4/1/2004 |
na |
10/1/2004 |
na |
F23a* |
Fertility and Infertility History |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2001a |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
F04*/F24 |
Alcohol, Drugs & Sexual
Behavior |
8/15/1994c |
na |
6/15/1997 |
na |
10/1/98 |
na |
4/1/1999 |
na |
10/1/1999 |
na |
4/1/2000a |
na |
4/1/2000a |
na |
4/1/2000a |
na |
10/1/2001a |
na |
10/1/2001a |
na |
10/1/2002 |
na |
4/1/2003 |
na |
10/1/2003 |
na |
4/1/2004 |
na |
10/1/2004 |
na |
F05*/F25 |
Health Care Utilization |
8/15/1994c |
na |
4/1/1995 |
na |
10/1/1998a |
na |
10/1/1998a |
na |
10/1/1998a |
na |
10/1/1998b |
na |
10/1/1998b |
na |
10/1/1998b |
na |
10/1/1998b |
na |
10/1/1998b |
na |
10/1/1998b |
na |
10/1/1998b |
na |
10/1/1998b |
na |
4/1/2004 |
na |
10/1/2004 |
na |
F25a* |
Health Care Utilization
Supplement |
na |
na |
8/1/1995 |
na |
10/1/1998a |
na |
na |
na |
10/1/1998a |
na |
na |
na |
10/1/1998a |
na |
na |
na |
10/1/1998a |
na |
10/1/1998a |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
F06*/F26 |
Psychosocial |
10/15/1994d |
na |
4/1/1995 |
na |
10/1/1998 |
na |
10/1/1998b |
na |
na |
na |
10/1/1998c |
na |
na |
na |
10/1/1998d |
na |
10/1/1998d |
na |
10/1/1998d |
na |
10/1/1998d |
na |
10/1/1998d |
na |
10/1/2003 |
na |
10/1/2003 |
na |
10/1/2003 |
na |
F29 |
Blood Specimen Collection Form |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/2/2004 |
na |
4/2/2004a |
na |
F29a |
Antiviral Usage Assessment for
Blood Draw |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/1999 |
na |
10/1/1999b |
na |
10/1/2000 |
na |
10/1/2000 |
na |
10/1/2001 |
na |
10/1/2001a |
na |
10/1/2002 |
na |
4/1/2003 |
na |
4/1/2003a |
na |
4/1/2004 |
na |
10/1/2004 |
na |
FHX* |
Family and Personal History |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2001 |
na |
10/1/2001b |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
INT* |
Interim Events Form |
na |
na |
na |
na |
na |
na |
4/1/1999 |
na |
10/1/1999 |
na |
10/1/1999 |
na |
10/1/2000 |
na |
10/1/2000a |
na |
10/1/2000b |
na |
10/1/2000b |
na |
10/1/2000c |
na |
10/1/2000c |
na |
10/1/2000c |
na |
10/1/2000c |
na |
na |
na |
MS01 |
MS: Specimen Collection for
Metabolic Study |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
6/13/2003a |
na |
6/13/2003a |
na |
6/11/2004 |
na |
6/11/2004a |
na |
NC01a |
Interviewer Script |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2004 |
na |
NC01b |
Interviewer Script |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2004 |
na |
NC02b |
Spanish Word List (WAT) |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2004b |
10/1/2004b |
NC03 |
Educational Experience |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2004 |
na |
NI01* |
NIDA Health Care Utilization
Interview |
na |
na |
11/1/1996c |
na |
10/1/1998a |
na |
10/1/98a |
na |
10/1/1998b |
na |
10/1/1998b |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
OP02* |
Oral Interview |
3/1/1995 |
na |
3/1/1995 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/1998 |
na |
10/1/2003 |
na |
10/1/2003 |
na |
na |
na |
PK02 |
PK: Current Antiretroviral
Medication Use |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
4/1/2003a |
na |
4/1/2003b |
na |
10/1/2004 |
na |
PK02a |
PK: Antiretroviral Adherence |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003a |
na |
4/1/2003a |
na |
PK03 |
PK: Recent Illnesses, Concurrent
Meds & OB/GYN History |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
4/1/2003a |
na |
4/1/2003a |
na |
4/1/2003a |
na |
PK04 |
PK: Recent Substance Use |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003 |
na |
4/1/2003 |
na |
S2* |
New
Recruit Sreening Form |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
10/1/2001 |
na |
10/1/2001 |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
SSSCR |
SS: Sex steroid Screening Form |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
na |
4/1/2003a |
na |
4/1/2003 |
na |
4/1/2003b |
na |
4/1/2003b |
na |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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