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Questionnaires

The Family Health History and Health Appraisal questionnaires were used to collect information on childhood maltreatment, household dysfunction, and other socio-behavioral factors examined in the ACE Study. The questionnaires are not copyrighted and there are no fees for their use.

As a courtesy, a copy of articles on any research conducted using items from the questionnaires is requested.

Family Health History Questionnaire

Male Version [PDF–183KB]

Female Version [PDF–196KB]

Health Appraisal Questionnaire

Male Version [PDF–208KB]

Female Version [PDF–109KB]

 

 
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