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Questionnaires

Norway Facial Clefts Study (NCL)

For more information about Norway Facial Clefts Study questionnaires, contact Allen J. Wilcox, M.D., Ph.D.

Pregnancy, Heredity and Environment Questionnaire (English) (http://www.niehs.nih.gov/research/atniehs/labs/epi/studies/ncl/ncl_pregnancy_en.pdf)  Download Adobe Reader (137K)

Pregnancy, Heredity and Environment Questionnaire (Norweigian) (http://www.niehs.nih.gov/research/atniehs/labs/epi/studies/ncl/ncl_pregnancy_nor.pdf)  Download Adobe Reader (134K)
The purpose of this questionnaire is to learn more about what can cause birth defects. The questions are related to the mother's health, diet, living conditions and exposure to various agents during pregnancy as well as history of cleft palette.

Dietary Habits Questionnaire (English) (http://www.niehs.nih.gov/research/atniehs/labs/epi/studies/ncl/ncl_nutrition_en.pdf)  Download Adobe Reader (400K)

Dietary Habits Questionnaire (Norweigian) (http://www.niehs.nih.gov/research/atniehs/labs/epi/studies/ncl/ncl_nutrition_nor.pdf)  Download Adobe Reader (480K)
The purpose of this questionnaire is to learn more about the mother's dietary habits during the first three months of pregnancy

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This page URL: http://www.niehs.nih.gov/research/atniehs/labs/epi/studies/ncl/question.cfm
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Last Reviewed: May 12, 2007