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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.
One or more documents on this Web page is available in Portable Document Format
(PDF). You will need Acrobat
Reader (a free application) to view and print these documents.
Family Health History Questionnaire
Male Version (PDF–190K)
Female Version (PDF–180K)
Health Appraisal Questionnaire
Male Version (PDF–85K)
Female Version (PDF–89K)
Page last reviewed: January 10, 2008
Page last modified: December 12, 2005
Content source: Division of Adult
and Community Health, National
Center for Chronic Disease Prevention and Health Promotion |
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