CDE Detailed Report

Disease: Parkinson's Disease
Sub-Domain: Epidemiology/Environmental History
CRF: Risk Factor Questionnaire (RFQ) - Residential History

Displaying 1 - 50 of 79
CDE ID CDE Name Variable Name Definition Short Description Question Text Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C08723 Risk Factor Questionnaire (RFQ) - age 66 and over residential history residence state text RFQResHxAge66OvrRsdncStateTxt Text specifying the participant's/subject's state of residence from 66+ years of age Text specifying the participant's/subject's state of residence from 66+ years of age State Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08691 Risk Factor Questionnaire (RFQ) - age 36 45 residential history residence duration RFQAge3645ResHxResDur Duration at residence lived from ages 36-45 Duration at residence lived from ages 36-45 Duration at Residence Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08702 Risk Factor Questionnaire (RFQ) - age 46 55 residential history residence city text RFQAge4655ResHxResCtyTxt Text specifying the participant's/subject's city or town of residence from 46-55 years of age Text specifying the participant's/subject's city or town of residence from 46-55 years of age City/Town Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C17704 Risk Factor Questionnaire (RFQ) - age 18 25 residential history residence street address text RFQAge1825ResdnceStAddressTxt Text specifying the partitipant's/subject's street address of residence from 18-25 years of age Text specifying the participant's/subject's street address of residence from 18-25 years of age Street Address Alphanumeric Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-08-30 17:06:52.8 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08670 Risk Factor Questionnaire (RFQ) - birth age 17 residential history first residence pesticide use frequency RFQBrthAg17ResHxFstRsPstUsFreq Frequency of pesticide spraying near the participant's/subject's first residence during the span of residence Frequency of pesticide spraying near the participant's/subject's first residence during the span of residence How often did the spraying happen <1 time per year;1-3 times per year;4-10 times per year;>10 times per year;Don't know <1 time per year;1-3 times per year;4-10 times per year;>10 times per year;Don't know Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08713 Risk Factor Questionnaire (RFQ) - age 56 65 residential history residence state text RFQResHxAg5665ResdnceStateTxt Text specifying the participant's/subject's state of residence from 56-65 years of age Text specifying the participant's/subject's state of residence from 56-65 years of age State Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08681 Risk Factor Questionnaire (RFQ) - age 26 35 residential history residence duration RFQAge2635ResHxResDur Duration at residence lived from ages 26-35 Duration at residence lived from ages 26-35 Duration at Residence Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08724 Risk Factor Questionnaire (RFQ) - age 66 and over residential history residence zip code number RFQResHxAge66OvrRsdncZipCdeNum Number specifying the participant's/subject's zip code of residence from 66+ years of age Number specifying the participant's/subject's zip code of residence from 66+ years of age Zip Code Numeric Values

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C08692 Risk Factor Questionnaire (RFQ) - age 36 45 residential history residence city text RFQAge3645ResHxResCtyTxt Text specifying the participant's/subject's city or town of residence from 36-45 years of age Text specifying the participant's/subject's city or town of residence from 36-45 years of age City/Town Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08703 Risk Factor Questionnaire (RFQ) - age 46 55 residential history residence state text RFQAge4655ResHxResStTxt Text specifying the participant's/subject's state of residence from 46-55 years of age Text specifying the participant's/subject's state of residence from 46-55 years of age State Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C17705 Risk Factor Questionnaire (RFQ) - age 26 35 residential history residence street address text RFQAge2635ResdnceStAddressTxt Text specifying the partitipant's/subject's street address of residence from 26-35 years of age Text specifying the participant's/subject's street address of residence from 26-35 years of age Street Address Alphanumeric Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-08-30 17:06:52.8 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08671 Risk Factor Questionnaire (RFQ) - age 18 25 residential history residence duration RFQAge1825ResHxResDur Duration at residence lived from ages 18-25 Duration at residence lived from ages 18-25 Duration at Residence Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08714 Risk Factor Questionnaire (RFQ) - age 56 65 residential history residence zip code number RFQResHxAg5665RsdncZipCodeNum Number specifying the participant's/subject's zip code of residence from 56-65 years of age Number specifying the participant's/subject's zip code of residence from 56-65 years of age Zip Code Numeric Values

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C08682 Risk Factor Questionnaire (RFQ) - age 26 35 residential history residence city text RFQAge2635ResHxResCtyTxt Text specifying the participant's/subject's city or town of residence from 26-35 years of age Text specifying the participant's/subject's city or town of residence from 26-35 years of age City/Town Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08725 Risk Factor Questionnaire (RFQ) - age 66 and over residential history residence country text RFQResHxAge66OvrResdncCntryTxt Text specifying the participant's/subject's country of residence from 66+ years of age Text specifying the participant's/subject's country of residence from 66+ years of age Country Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08661 Risk Factor Questionnaire (RFQ) - residential history age 0 17 residence duration RFQResHistAge017ResDur Duration at residence lived from birth through age 17 Duration at residence lived from birth through age 17 Duration at Residence Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08693 Risk Factor Questionnaire (RFQ) - age 36 45 residential history residence state text RFQAge3645ResHxResStTxt Text specifying the participant's/subject's state of residence from 36-45 years of age Text specifying the participant's/subject's state of residence from 36-45 years of age State Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08704 Risk Factor Questionnaire (RFQ) - age 46 55 residential history residence zip code number RFQAge4655ResHxResZipCdNum Number specifying the participant's/subject's zip code of residence from 46-55 years of age Number specifying the participant's/subject's zip code of residence from 46-55 years of age Zip Code Numeric Values

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C17706 Risk Factor Questionnaire (RFQ) - age 36 45 residential history residence street address text RFQAge3645ResdnceStAddressTxt Text specifying the partitipant's/subject's street address of residence from 36-45 years of age Text specifying the participant's/subject's street address of residence from 36-45 years of age Street Address Alphanumeric Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-08-30 17:06:52.8 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08672 Risk Factor Questionnaire (RFQ) - age 18 25 residential history residence city text RFQAge1825ResHxResCityTxt Text specifying the participant's/subject's city or town of residence from 18-25 years of age Text specifying the participant's/subject's city or town of residence from 18-25 years of age City/Town Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08715 Risk Factor Questionnaire (RFQ) - age 56 65 residential history residence country text RFQResHxAg5665RsdncCountryTxt Text specifying the participant's/subject's country of residence from 56-65 years of age Text specifying the participant's/subject's country of residence from 56-65 years of age Country Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08683 Risk Factor Questionnaire (RFQ) - age 26 35 residential history residence state text RFQAge2635ResHxResStTxt Text specifying the participant's/subject's state of residence from 26-35 years of age Text specifying the participant's/subject's state of residence from 26-35 years of age State Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08726 Risk Factor Questionnaire (RFQ) - age 66 and over residential history residence location type RFQResHxAge66OvrRsdncLocTyp Type describing the participant's/subject's location of residence from 66+ years of age Type describing the participant's/subject's location of residence from 66+ years of age At the time you lived there, was the residence located in a… Large City (>250,000 people);Midsized city (100,000-250,000 people);Small town (2,500-24,999 people);Rural, non-farm;Suburb of a large city;Rural, farm;Large town (25,000-99,999 people) Large City (>250,000 people);Midsized city (100,000-250,000 people);Small town (2,500-24,999 people);Rural, non-farm;Suburb of a large city;Rural, farm;Large town (25,000-99,999 people) Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08662 Risk Factor Questionnaire (RFQ) - residential history age 0 17 first residence city text RFQResHxAg0171stResdnceCityTxt Text specifying the participant's/subject's first city or town of residence Text specifying the participant's/subject's first city or town of residence City/Town Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08694 Risk Factor Questionnaire (RFQ) - age 36 45 residential history residence zip code number RFQAge3645ResHxResZipCodeNum Number specifying the participant's/subject's zip code of residence from 36-45 years of age Number specifying the participant's/subject's zip code of residence from 36-45 years of age Zip Code Numeric Values

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C08705 Risk Factor Questionnaire (RFQ) - age 46 55 residential history residence country text RFQAge4655ResHxResCntryTxt Text specifying the participant's/subject's country of residence from 46-55 years of age Text specifying the participant's/subject's country of residence from 46-55 years of age Country Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C17707 Risk Factor Questionnaire (RFQ) - age 46 55 residential history residence street address text RFQAge4655ResdnceStAddressTxt Text specifying the partitipant's/subject's street address of residence from 46-55 years of age Text specifying the participant's/subject's street address of residence from 46-55 years of age Street Address Alphanumeric Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-08-30 17:06:52.8 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08673 Risk Factor Questionnaire (RFQ) - age 18 25 residential history residence state text RFQAge1825ResHxResStateTxt Text specifying the participant's/subject's state of residence from 18-25 years of age Text specifying the participant's/subject's state of residence from 18-25 years of age State Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08716 Risk Factor Questionnaire (RFQ) - age 56 65 residential history residence location type RFQResHxAg5665RsdncLocationTyp Type describing the participant's/subject's location of residence from 56-65 years of age Type describing the participant's/subject's location of residence from 56-65 years of age At the time you lived there, was the residence located in a… Large City (>250,000 people);Midsized city (100,000-250,000 people);Small town (2,500-24,999 people);Rural, non-farm;Suburb of a large city;Rural, farm;Large town (25,000-99,999 people) Large City (>250,000 people);Midsized city (100,000-250,000 people);Small town (2,500-24,999 people);Rural, non-farm;Suburb of a large city;Rural, farm;Large town (25,000-99,999 people) Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08684 Risk Factor Questionnaire (RFQ) - age 26 35 residential history residence zip code number RFQAge2635ResHxResZipCdNum Number specifying the participant's/subject's zip code of residence from 26-35 years of age Number specifying the participant's/subject's zip code of residence from 26-35 years of age Zip Code Numeric Values

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C08727 Risk Factor Questionnaire (RFQ) - age 66 and over residential history residence well water indicator RFRsHxAge66OvrRsdncWellWterInd Indicator as to whether the participant's/subject's source of drinking water was a private well at the residence from 66+ years of age Indicator as to whether the participant's/subject's source of drinking water was a private well at the residence from 66+ years of age Was your main source of drinking water at this residence a private well No;Yes No;Yes Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08663 Risk Factor Questionnaire (RFQ) - residential history age 0 17 first residence state text RFQResHxAge0171stRsdncStateTxt Text specifying the participant's/subject's first state of residence Text specifying the participant's/subject's first state of residence State Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08695 Risk Factor Questionnaire (RFQ) - age 36 45 residential history residence country text RFQAge3645ResHxResCntryTxt Text specifying the participant's/subject's country of residence from 36-45 years of age Text specifying the participant's/subject's country of residence from 36-45 years of age Country Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08706 Risk Factor Questionnaire (RFQ) - age 46 55 residential history residence location type RFQAge4655ResHxResLocTyp Type describing the participant's/subject's location of residence from 46-55 years of age Type describing the participant's/subject's location of residence from 46-55 years of age At the time you lived there, was the residence located in a… Large City (>250,000 people);Midsized city (100,000-250,000 people);Small town (2,500-24,999 people);Rural, non-farm;Suburb of a large city;Rural, farm;Large town (25,000-99,999 people) Large City (>250,000 people);Midsized city (100,000-250,000 people);Small town (2,500-24,999 people);Rural, non-farm;Suburb of a large city;Rural, farm;Large town (25,000-99,999 people) Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C17708 Risk Factor Questionnaire (RFQ) - age 56 65 residential history residence street address text RFQAge5665ResdnceStAddressTxt Text specifying the partitipant's/subject's street address of residence from 56-65 years of age Text specifying the participant's/subject's street address of residence from 56-65 years of age Street Address Alphanumeric Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-08-30 17:06:52.8 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08674 Risk Factor Questionnaire (RFQ) - age 18 25 residential history residence zip code number RFQAge1825ResHxResZipCdNum Number specifying the participant's/subject's zip code of residence from 18-25 years of age Number specifying the participant's/subject's zip code of residence from 18-25 years of age Zip Code Numeric Values

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C08717 Risk Factor Questionnaire (RFQ) - age 56 65 residential history residence well water indicator RFQResHxAg5665RsdncWellWterInd Indicator as to whether the participant's/subject's source of drinking water was a private well at the residence from 56-65 years of age Indicator as to whether the participant's/subject's source of drinking water was a private well at the residence from 56-65 years of age Was your main source of drinking water at this residence a private well No;Yes No;Yes Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08685 Risk Factor Questionnaire (RFQ) - age 26 35 residential history residence country text RFQAge2635ResHxResCntryTxt Text specifying the participant's/subject's country of residence from 26-35 years of age Text specifying the participant's/subject's country of residence from 26-35 years of age Country Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08728 Risk Factor Questionnaire (RFQ) - age 66 and over residential history residence near farm fields indicator RFQRsHxAg66OvrRsdncNrFrmFldInd Indicator as to whether the participant's/subject's residence from 66+ years of age was located near farm fields (within 1/4mile) Indicator as to whether the participant's/subject's residence from 66+ years of age was located near farm fields (within 1/4mile) Was this residence located near farm fields (within ? mile) No;Yes No;Yes Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08664 Risk Factor Questionnaire (RFQ) - residential history age 0 17 first residence zip code number RFQResHxAge0171stRsdncZpCdNum Number specifying the participant's/subject's first zip code of residence Number specifying the participant's/subject's first zip code of residence Zip Code Numeric Values

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C08696 Risk Factor Questionnaire (RFQ) - age 36 45 residential history residence location type RFQAge3645ResHxResLocTyp Type describing the participant's/subject's location of residence from 36-45 years of age Type describing the participant's/subject's location of residence from 36-45 years of age At the time you lived there, was the residence located in a… Large City (>250,000 people);Midsized city (100,000-250,000 people);Small town (2,500-24,999 people);Rural, non-farm;Suburb of a large city;Rural, farm;Large town (25,000-99,999 people) Large City (>250,000 people);Midsized city (100,000-250,000 people);Small town (2,500-24,999 people);Rural, non-farm;Suburb of a large city;Rural, farm;Large town (25,000-99,999 people) Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08707 Risk Factor Questionnaire (RFQ) - age 46 55 residential history residence well water indicator RFQAge4655ResHxResWellWtrInd Indicator as to whether the participant's/subject's source of drinking water was a private well at the residence from 46-55 years of age Indicator as to whether the participant's/subject's source of drinking water was a private well at the residence from 46-55 years of age Was your main source of drinking water at this residence a private well No;Yes No;Yes Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C17709 Risk Factor Questionnaire (RFQ) - age 66 and over residential history residence street address text RFQAge66OvrResdnceStAddressTxt Text specifying the partitipant's/subject's street address of residence from 66+ years of age Text specifying the participant's/subject's street address of residence from 66+ years of age Street Address Alphanumeric Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-08-30 17:06:52.8 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08675 Risk Factor Questionnaire (RFQ) - age 18 25 residential history residence country text RFQAge1825ResHxResCntryTxt Text specifying the participant's/subject's country of residence from 18-25 years of age Text specifying the participant's/subject's country of residence from 18-25 years of age Country Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08718 Risk Factor Questionnaire (RFQ) - age 56 65 residential history residence near farm field indicator RFQResHxAg5665RsdncNrFrmFldInd Indicator as to whether the participant's/subject's residence from 56-65 years of age was located near farm fields (within 1/4mile) Indicator as to whether the participant's/subject's residence from 56-65 years of age was located near farm fields (within 1/4mile) Was this residence located near farm fields (within ? mile) No;Yes No;Yes Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08686 Risk Factor Questionnaire (RFQ) - age 26 35 residential history residence location type RFQAge2635ResHxResHxResLocTyp Type describing the participant's/subject's location of residence from 26-35 years of age Type describing the participant's/subject's location of residence from 26-35 years of age At the time you lived there, was the residence located in a… Large City (>250,000 people);Midsized city (100,000-250,000 people);Small town (2,500-24,999 people);Rural, non-farm;Suburb of a large city;Rural, farm;Large town (25,000-99,999 people) Large City (>250,000 people);Midsized city (100,000-250,000 people);Small town (2,500-24,999 people);Rural, non-farm;Suburb of a large city;Rural, farm;Large town (25,000-99,999 people) Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08729 Risk Factor Questionnaire (RFQ) - age 66 and over residential history residence pesticide use indicator RFQRsHXAg66OvrRsdncPstUseInd Indicator as to whether the participant's/subject's residence from 66+ years of age was located near pesticide spraying activities during the span of residence Indicator as to whether the participant's/subject's residence from 66+ years of age was located near pesticide spraying activities during the span of residence Was there pesticide spraying at or around this residence when you lived there No;Yes No;Yes Alphanumeric

If 'No,' skip to "Group living one month 35 years of age indicator"

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08665 Risk Factor Questionnaire (RFQ) - birth age 17 residential history first residence country text RFQBrthAg17ResHxFstResCntryTxt Text specifying the participant's/subject's first country of residence Text specifying the participant's/subject's first country of residence Country Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08697 Risk Factor Questionnaire (RFQ) - age 36 45 residential history residence well water indicator RFQAge3645ResHxResWlWtrInd Indicator as to whether the participant's/subject's source of drinking water was a private well at the residence from 36-45 years of age Indicator as to whether the participant's/subject's source of drinking water was a private well at the residence from 36-45 years of age Was your main source of drinking water at this residence a private well No;Yes No;Yes Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08708 Risk Factor Questionnaire (RFQ) - age 46 55 residential history residence near farm field indicator RFQAge4655ResHxResNrFrmFldInd Indicator as to whether the participant's/subject's residence from 46-55 years of age was located near farm fields (within 1/4mile) Indicator as to whether the participant's/subject's residence from 46-55 years of age was located near farm fields (within 1/4mile) Was this residence located near farm fields (within ? mile) No;Yes No;Yes Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Residential History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

CSV