Surveys and Forms

VACS 3
Baseline

VACS 3
Follow Up
VACS 5 VACS
Baseline
Follow Up 1 Follow Up 2 Follow Up 3
Patient Surveys
ID
 
 
 
 
 
 
 
 
 
 
 
 
 
 
GM --------  -------- 
 
 
 
 
 
 
 
 
 
 
Provider Surveys
ID
 
 
 
 
 
 
 
 
 
 
 
 
 
 
GM --------  -------- 
 
 
 
 
 
 
 
 
 
 
Provider Characteristics -------  ------- 
 
 
 
 
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Other

 ADS Alcohol Use Questionnaire
 Alcohol Dependence Scale
 Short Inventory of Problems
 VACS Baseline Checklist
 VACS Cause Death Form
 Analysis Proposal Request Form
 3-28-03 VACS 3 Chart Form
 6-18-2003 VACS 3 Manual for Chart Extraction