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TLC Trial Forms & Instruments

Operational forms from the TLC Trial with phase/visit context. Click any form to open.

Screening

SCREEN.03 — Parent/guardian interview & eligibility review
SCRNLOG.03 — Participant referral sheet / screening log
SCRNRVW.04 — Pre-randomization eligibility review
HOUSES.04 — Residence information (Pre-Randomization Visit 1)

First Visit

V1LOG.03 — Participant tracking form
V1REVIEW.04 — Review of eligibility lab results (V1)
VISIT1A.04 — Pre-Randomization Visit 1
VISIT1A.04 — Repeat eligibility lab work (V1A)

Diaries

MEDDIARY.00 — Medication diary
VITDIARY.00 — Vitamin diary

Home Assessment, Inspection & Cleanup

HOMECHAR.03 — Home characteristics
HOMELOG.03 — Home assessment log
INSPECT.01 — Home visual inspection
FLOORPLN.03 — Home floor plans
DUSTWIPE.03 — Dust wipe collection
CLEANUP.03 — Home clean-up
H2 Manual — Home cleanup procedures
ENVRVW.03 — Environmental eligibility review

Second Visit

FAMCHAR.03 — Family characteristics interview
NONCMPLY.03 — Visit non-compliance / ineligibility
REFUSE.03 — Non-enrollment / refusal
VISIT2.04 — Pre-Randomization Visit 2 or 2A

Initial Psychometric Assessment

PSYCH2.03 — Psychometric assessment (older children)
PSYCH1QA.01 — Review of psychometric assessment tapes (younger)
PSYCH2QA.01 — Review of psychometric assessment tapes (older)
PSYCH3.01 — NEPSY session data for TLC children
WAIS.04 — Wechsler Adult Intelligence Scale for Parents

Randomization and Treatment

RANDO.04 — Randomization worksheet
LABRVW.04 — Local lab review summary
TX0.04 — Initiation of treatment
TX2.05 — Review of medications & physical exam
TX3.05 — Treatment follow-up
RETREAT.05 — Retreatment worksheet
ADE.04 — Adverse drug experience case report

Followup

LTL_FUP.03 — Mid-year post-treatment follow-up visit
BIG_FUP.04 — Annual follow-up visit
PSYCH3.01 — Psychometric assessment follow-up (NEPSY)