Forms and documentation

Uniform Data Set (UDS)

COVID Impact Survey F2/F3 v2 aims to collect valuable information about COVID vaccinations, infections, and hospitalizations of the UDS participants. Collecting this valuable data will be important in understanding the impact of COVID in the AD community.

ADRCs will need to provide information about local vaccine availability to participants that are interested. The CDC has provided this guidance for residents that are living in LT care facilities.

Essential documents

Form, EnglishForm, SpanishDED
COVID-19 Impact Survey F2/F3 v2

This optional survey captures data on the impact COVID-19 has had on a participant including testing, course of illness, and medical consequences.

 In Development 
COVID-19 Technology Accessibility Survey F1 v1

This optional survey captures a participant's preferences regarding remote visits and use of technology.


REDCap Forms

ADRCs can upload an XML file to their own REDCap installation that will provide them with electronic versions of the forms which can be used on iPads in waiting rooms, disseminated by email to participants, or used as clinician-filled forms.

Follow this link to get started.

Data Collection and Submission

ADRCs should begin collection of COVID Impact data immediately. The COVID Impact Survey form should be administered at the annual visit or could be deployed between visits. The COVID Impact Survey is designed to capture new hospitalizations and outpatient treatments. We encourage you to adopt this new version. If the length of the form concerns you, please read the new COVID guidance document to learn more about adopting this new version.

NACC does not currently have a data submission system in place for the COVID Impact Survey F2/F3 v2. We are developing a new data architecture and submission system at NACC. We will update ADRCs as this system is developed and ask centers to submit the data previously collected. Then this data will then be reported to NIA, reflected in your monthly reports, and made accessible to investigators.