Skip Ribbon Commands
Skip to main content
Sign In

Skip Navigation LinksForms

WHI Forms

WHI study forms from all three phases (WHI, Extension Study 1, and Extension Study 2), along with adjudication forms and form instructions, are available on this site.  Forms completed by participants are also available in Spanish.

Displayed below are English-language Extension Study 2 (ES2) forms.  Additional form types are available by navigating to the following links.

Please click on the Form ID, located under the "Name" heading, to access an image of the desired form.

Extension Study 2 (English) Forms (2010-2020)

  
  
Study Phase
  
  
F009 v8.2Participation StatusES2Form English
F023 v8.2Search to Locate ParticipantES2Form English
F024 v8Retention WorksheetES1, ES2Form English
F033 v12.1Medical History UpdateES2Form English
F115 v1Extension Consent StatusES2Form English
F120 v8.1Initial Notification of DeathES1, ES2Form English
F120 v8.3Initial Notification of DeathES2Form English
F121 v9.2Report of Cardiovascular OutcomeES2Adjudication
F123 v8.2Report of Fracture OutcomeES2Adjudication
F124 v9Report of Death (Final)ES2Adjudication
F125 v8.2Summary of HospiralizationES1, ES2Form English
F126 v8.2Report of VTEES2Adjudication
F130 v9Report of CancerES2Adjudication
F132 v8.3Report of StrokeES1, ES2Adjudication
F135 vAHeart Failure DiagnosisES2Adjudication
F136 vAHeart Failure AbstractionES2Adjudication
F151 v9.2Activities of Daily LivingES2Form English
F153 v1Medication and Supplement InventoryES1, ES2Form English
F155 v1Lifestyle QuestionnaireES2Form English
F156 v1.1Supplemental Questionnaire (collection Oct-13 through Dec-14; data available early 2015)ES2Form English
F157 v1Supplemental Questionnaire 2014-2015 (collection Oct-14 through Dec-15; data available by the end of 2016)ES2Form English
F158 v1Supplemental Questionnaire 2017 (to be mailed to participants beginning January 2017)ES2Form English
F301 v3WHI Long Life Study Home Visit (data available as of 2-28-14)ES2Form English
F340 v3LILAC Baseline QuestionnaireES2Form English
F370 v1LILAC Annual SurveyES2Form English
F521 v1Physical Activity QuestionnaireES2Form English