Biologic Specimen and Data Repository Information Coordinating Center

Activities of Daily Life (PDF - 380.1 KB)
Annual Clinic Visit (PDF - 3.3 MB)
Annual Medical - Medication - and Habits History (PDF - 1.7 MB)
Baseline Medical History (PDF - 1.8 MB)
Baseline Visit 1 (PDF - 2.1 MB)
Baseline Visit 2 (PDF - 1.1 MB)
Behavioral Evaluation (PDF - 766.0 KB)
CT Scan Coding form for Dementia (PDF - 405.1 KB)
Central Laboratory Results (PDF - 609.6 KB)
Clinic Visit Documentation (PDF - 1.9 MB)
Close-out and Transition (PDF - 216.4 KB)
Compliance Evaluation (PDF - 366.1 KB)
Demographics and Medical History (PDF - 494.1 KB)
Diagnostic Criteria for Depression (PDF - 153.3 KB)
Diagnostical Evaluation for Dementia (PDF - 1.8 MB)
Documentation of Refusal or Lost to Follow-up (PDF - 109.0 KB)
ECG Coding (PDF - 137.1 KB)
Final Report of Death (PDF - 163.3 KB)
Final Report of Morbid Event (PDF - 248.8 KB)
General Well-Being (PDF - 369.6 KB)
Initial Notification of Death (PDF - 112.7 KB)
Initial Notification of Morbid Event (PDF - 236.3 KB)
Local Laboratory Results (PDF - 142.7 KB)
Monitoring of SHEP Deaths (PDF - 143.8 KB)
Monitoring of SHEP Non-Fatal Events (PDF - 288.1 KB)
Neurological Evaluation for Stroke (PDF - 776.1 KB)
Neurological Evaluation for TIA (PDF - 171.5 KB)
Protocol Reveiw and Medical Scheduling Decision (PDF - 305.7 KB)
Randomization Record (PDF - 213.2 KB)
Receipt of Alert Level from Central Laboratory (PDF - 71.1 KB)
Report of Deviation from Protocol (PDF - 108.6 KB)
Report of Missed Quarterly or Annual Visit (PDF - 99.4 KB)
Report of Study Drug Disclosure (PDF - 92.9 KB)
SHEP Satisfaction and Attitude Questionnaire (PDF - 175.8 KB)
Scan Coding form for Stroke (PDF - 641.8 KB)
Short-care form (PDF - 845.2 KB)
Side Effects Questionnaire (PDF - 342.9 KB)
Silent MI (PDF - 142.7 KB)
Social Network Questionnaire (PDF - 613.9 KB)
Transition Telephone Contact Record (PDF - 60.5 KB)
Urine Chlorthalidone Results (PDF - 193.8 KB)