Forms and documentation

Using the Spanish-language UDS3 and FTLD Module forms

The following UDS v3 forms and documentation are now available in Spanish:

  • UDS3 initial visit forms
  • UDS3 follow-up visit forms
  • UDS3 telephone initial visit forms
  • UDS3 telephone follow-up forms
  • C2 neuropsychological battery
  • C2T neuropsychological battery
  • FTLD Module initial visit forms
  • FTLD Module follow-up visit forms
  • FTLD Module neuropsychological battery

Please note that no translation certificate is provided for the Spanish forms.

Centers have the option of administering the entire visit in Spanish, or combining Spanish and English forms. As of October 23, 2017, if any form is administered in Spanish or if a participant identifies as Hispanic/Latino, a new version of the Form Checklist — Form Z1X — is required (see instructions below).

For subjects who are returning for a follow-up visit and are completing the Neuropsychological Battery in Spanish, Centers have the option of completing either Form C1 (proprietary tests) or Form C2 (non-proprietary tests). The Spanish translation of the C1 battery is no longer accepted as part of the UDS v3 Initial Visit Packet. With the Spanish translation of the UDS v3 C2 battery available, NACC will cease purchasing licenses for the C1 battery as of October 23, 2017. If you wish to continue using the tests from the C1 battery, your Center must establish licensing agreements with the companies. The licensing companies are:

  • NCS Person Inc.: WAIS-R Digit Symbol Substitution subtest, WMS-R Digit Span Subtest, and WMS-R Logical Memory I subtest
  • PAR: Mini-Mental State Examination (MMSE)
  • Medica PanAmericana: 30 odd-numbered items from the Boston Diagnostic Aphasia Examination-3rd Edition Naming Test

Centers that piloted the Spanish forms should contact NACC (naccmail@uw.edu) to find out how to submit the pilot data.

New Form Checklist (Form Z1X)

Centers with participants who are Hispanic/Latino or who use any Spanish UDS v3 or Spanish FTLD Module forms must, as of October 23, 2017, complete the new Form Checklist (Form Z1X), indicating each form's language of administration. Also new to this Z1X Form is a section for recording the submission of the new Linguistic History Form (Form CLS; see below for instructions).

Starting April 2, 2018, NACC will no longer accept the Z1 version of the Form Checklist. At that time, all Centers will need to submit the new Form Z1X for all participants, regardless of ethnicity or language of administration.

Completing the Linguistic History Form (Form CLS)

Please complete the Linguistic History Form (Form CLS) for any participant who indicated Hispanic/Latino (1=Yes) ethnicity on their demographics form (Form A1), even if they completed no UDS forms in Spanish. Participants may decline completing the form. If a participant declines, the Center can simply indicate "No," not submitted, on Form Z1X.

For participants completing the Linguistic History Form: Form CLS is to be completed and submitted to NACC only ONCE. For newly enrolled participants, Form CLS should be completed at their initial visit. For participants who have already completed their initial visit, Form CLS should be completed at their next follow-up visit. The information used to complete CLS may be obtained from the participant or a co-participant.

If you’re unable to find what you’re looking for, please don’t hesitate to contact us.

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University of Washington

NACC is funded by the National Institute on Aging (U01 AG016976) and located in the Department of Epidemiology at the University of Washington School of Public Health, Walter A. Kukull, Ph.D., Director. © 2021 University of Washington