The Activity in Counseling Trial (ACT) Elements
Forms
Record
Format
1) Activities Inventory
PDF
2) Influences on Activity
PDF
3) 18-Month Adverse Events
PDF
4) Follow-up Adverse Events
PDF
5) Clinical Measures
PDF
6) Demographics and Medical History
PDF
7) Diet
PDF
8) SVO Disposition
PDF
9) SV1 Disposition
PDF
10) SV2 Disposition
PDF
11) 6-Month Follow-up Disposition
PDF
12) 12-Month Telephone Follow-up Dispostion
PDF
13) 24-Month A Follow-up Disposition
PDF
14) 24-Month B Follow-up Disposition
PDF
15) End of Study Survey
PDF
16) Follow-up Health Habits
PDF
17) Quality of Life
PDF
18) Heart Rate Variability
PDF
19) Max Graded Exercise Test
PDF
20) Baseline Medications
PDF
21) Medlant Variables
PDF
22) Physical Activity Recall
PDF
23) Physician End of Study Survey
PDF
24) Physical Exam
PDF
25) Pulse Wave Velocity Variables
PDF
26) Random Variables
PDF
27) Self Evaluation
PDF
28) Study Termination
PDF
29) Submax Graded Exercise Test
PDF
30) Telephone Pre-Screening
PDF
Please send us your feedback, comments, and questions
by using the appropriate link on the page,
Contact the NHLBI
.
Note to users of screen readers and other assistive technologies: please report your problems here.