| Name | Label | Folder | |
|---|---|---|---|
|
fam1
Mother smoke during pregnancy?
|
Mother smoke during pregnancy?
Did your child's biological mother smoke at least one cigarette a day while she was pregnant with your child? |
Family History | |
|
fam10
Mother's current weight
|
Mother's current weight | Family History | |
|
fam10_chk
Mother's current weight
|
Mother's current weight | Family History | |
|
fam10_tot_oz
Mother's current weight in ounces
|
Mother's current weight in ounces | Family History | |
|
fam3
Are there any full siblings?
|
Are there any full siblings?
These siblings have the same mother and father as the child |
Family History | |
|
fam3a
If YES, how many FULL sisters?
|
If YES, how many FULL sisters? | Family History | |
|
fam3b
If YES, how many FULL brothers?
|
If YES, how many FULL brothers? | Family History | |
|
fam4
Are there any half siblings?
|
Are there any half siblings?
These siblings only share one parent with the child |
Family History | |
|
fam4a
If YES, how many HALF sisters?
|
If YES, how many HALF sisters? | Family History | |
|
fam4b
If YES, how many HALF brothers?
|
If YES, how many HALF brothers? | Family History | |
|
fam5
Do any of the siblings have any of the following conditions?
|
Do any of the siblings have any of the following conditions? | Family History | |
|
fam5a1
Do any siblings have acute life threatening episode (ALTE)?
|
Do any siblings have acute life threatening episode (ALTE)?
Also known as acute life threatening episodes |
Family History | |
|
fam5a21
Number of full sisters with acute life threatening episode (ALTE)
|
Number of full sisters with acute life threatening episode (ALTE)
Also known as acute life threatening episodes |
Family History | |
|
fam5a21_chk
Full sisters have acute life threatening episode (ALTE)
|
Full sisters have acute life threatening episode (ALTE)
Also known as acute life threatening episodes |
Family History | |
|
fam5a22
Number of full brothers with acute life threatening episode (ALTE)
|
Number of full brothers with acute life threatening episode (ALTE)
Also known as acute life threatening episodes |
Family History | |
|
fam5a22_chk
Full brothers have acute life threatening episode (ALTE)
|
Full brothers have acute life threatening episode (ALTE)
Also known as acute life threatening episodes |
Family History | |
|
fam5a31
Number of half sisters with acute life threatening episode (ALTE)
|
Number of half sisters with acute life threatening episode (ALTE)
Also known as acute life threatening episodes |
Family History | |
|
fam5a31_chk
Half sisters have acute life threatening episode (ALTE)
|
Half sisters have acute life threatening episode (ALTE)
Also known as acute life threatening episodes |
Family History | |
|
fam5a32
Number of half brothers with acute life threatening episode (ALTE)
|
Number of half brothers with acute life threatening episode (ALTE)
Also known as acute life threatening episodes |
Family History | |
|
fam5a32_chk
Half brothers have acute life threatening episode (ALTE)
|
Half brothers have acute life threatening episode (ALTE)
Also known as acute life threatening episodes |
Family History | |
|
fam5b1
Any siblings with Sudden Infant Death Syndrome (SIDS)?
|
Any siblings with Sudden Infant Death Syndrome (SIDS)?
Also known as crib death or Sudden Infant Death Syndrome (SIDS) |
Family History | |
|
fam5b21
Number of full sisters with Sudden Infant Death Syndrome (SIDS)
|
Number of full sisters with Sudden Infant Death Syndrome (SIDS)
Also known as crib death or Sudden Infant Death Syndrome (SIDS) |
Family History | |
|
fam5b21_chk
Full sister has Sudden Infant Death Syndrome (SIDS)
|
Full sister has Sudden Infant Death Syndrome (SIDS)
Also known as crib death or Sudden Infant Death Syndrome (SIDS) |
Family History | |
|
fam5b22
Number of full brothers with Sudden Infant Death Syndrome (SIDS)
|
Number of full brothers with Sudden Infant Death Syndrome (SIDS)
Also known as crib death or Sudden Infant Death Syndrome (SIDS) |
Family History | |
|
fam5b22_chk
Full brothers has Sudden Infant Death Syndrome (SIDS)
|
Full brothers has Sudden Infant Death Syndrome (SIDS)
Also known as crib death or Sudden Infant Death Syndrome (SIDS) |
Family History | |
|
fam5b31
Number of half sisters with Sudden Infant Death Syndrome (SIDS)
|
Number of half sisters with Sudden Infant Death Syndrome (SIDS)
Also known as crib death or Sudden Infant Death Syndrome (SIDS) |
Family History | |
|
fam5b31_chk
Half sister has Sudden Infant Death Syndrome (SIDS)
|
Half sister has Sudden Infant Death Syndrome (SIDS)
Also known as crib death or Sudden Infant Death Syndrome (SIDS) |
Family History | |
|
fam5b32
Number of half brothers with Sudden Infant Death Syndrome (SIDS)
|
Number of half brothers with Sudden Infant Death Syndrome (SIDS)
Also known as crib death or Sudden Infant Death Syndrome (SIDS) |
Family History | |
|
fam5b32_chk
Half brother has Sudden Infant Death Syndrome (SIDS)
|
Half brother has Sudden Infant Death Syndrome (SIDS)
Also known as crib death or Sudden Infant Death Syndrome (SIDS) |
Family History | |
|
fam5c1
Any siblings with an anxiety disorder?
|
Any siblings with an anxiety disorder? | Family History | |
|
fam5c21
Number of full sisters with an anxiety disorder
|
Number of full sisters with an anxiety disorder | Family History | |
|
fam5c21_chk
Full sister has an anxiety disorder
|
Full sister has an anxiety disorder | Family History | |
|
fam5c22
Number of full brothers with an anxiety disorder
|
Number of full brothers with an anxiety disorder | Family History | |
|
fam5c22_chk
Full brother has an anxiety disorder
|
Full brother has an anxiety disorder | Family History | |
|
fam5c31
Number of half sisters with an anxiety disorder
|
Number of half sisters with an anxiety disorder | Family History | |
|
fam5c31_chk
Half sisters have an anxiety disorder
|
Half sisters have an anxiety disorder | Family History | |
|
fam5c32
Number of half brothers with anxiety disorder
|
Number of half brothers with anxiety disorder | Family History | |
|
fam5c32_chk
Half brothers have an anxiety disorder
|
Half brothers have an anxiety disorder | Family History | |
|
fam5d1
Any siblings with asthma?
|
Any siblings with asthma? | Family History | |
|
fam5d21
Number of full sisters with have asthma
|
Number of full sisters with have asthma | Family History | |
|
fam5d21_chk
Full sisters have asthma
|
Full sisters have asthma | Family History | |
|
fam5d22
Number of full brothers with asthma
|
Number of full brothers with asthma | Family History | |
|
fam5d22_chk
Full brother has asthma
|
Full brother has asthma | Family History | |
|
fam5d31
Number of half sisters with asthma
|
Number of half sisters with asthma | Family History | |
|
fam5d31_chk
Half sister has asthma
|
Half sister has asthma | Family History | |
|
fam5d32
Number of half brothers with asthma
|
Number of half brothers with asthma | Family History | |
|
fam5d32_chk
Half brother has asthma
|
Half brother has asthma | Family History | |
|
fam5e1
Any siblings with Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder(ADHD)?
|
Any siblings with Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder(ADHD)? | Family History | |
|
fam5e21
Number of full sisters with Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder(ADHD)
|
Number of full sisters with Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder(ADHD) | Family History | |
|
fam5e21_chk
Full sister has Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder(ADHD)
|
Full sister has Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder(ADHD) | Family History | |
|
fam5e22
Number of full brothers with Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder(ADHD)
|
Number of full brothers with Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder(ADHD) | Family History | |
|
fam5e22_chk
Full brother has Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder(ADHD)
|
Full brother has Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder(ADHD) | Family History | |
|
fam5e31
Number of half sisters with Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder(ADHD)
|
Number of half sisters with Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder(ADHD) | Family History | |
|
fam5e31_chk
Half sister has Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder(ADHD)
|
Half sister has Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder(ADHD) | Family History | |
|
fam5e32
Number of half brothers with Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder(ADHD)
|
Number of half brothers with Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder(ADHD) | Family History | |
|
fam5e32_chk
Half brother has Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder(ADHD)
|
Half brother has Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder(ADHD) | Family History | |
|
fam5f1
Any siblings with cancer?
|
Any siblings with cancer? | Family History | |
|
fam5f21
Number of full sisters with cancer
|
Number of full sisters with cancer | Family History | |
|
fam5f21_chk
Full sister has cancer
|
Full sister has cancer | Family History | |
|
fam5f22
Number of full brothers with cancer
|
Number of full brothers with cancer | Family History | |
|
fam5f22_chk
Full brother has cancer
|
Full brother has cancer | Family History | |
|
fam5f31
Number of half sisters with cancer
|
Number of half sisters with cancer | Family History | |
|
fam5f31_chk
Half sister has cancer
|
Half sister has cancer | Family History | |
|
fam5f32
Number of half brothers with cancer
|
Number of half brothers with cancer | Family History | |
|
fam5f32_chk
Half brother has cancer
|
Half brother has cancer | Family History | |
|
fam5g1
Any siblings with cerebral palsy?
|
Any siblings with cerebral palsy? | Family History | |
|
fam5g21
Number of full sisters with cerebral palsy
|
Number of full sisters with cerebral palsy | Family History | |
|
fam5g21_chk
Full sister has cerebral palsy
|
Full sister has cerebral palsy | Family History | |
|
fam5g22
Number of full brothers with cerebral palsy
|
Number of full brothers with cerebral palsy | Family History | |
|
fam5g22_chk
Full brother has cerebral palsy
|
Full brother has cerebral palsy | Family History | |
|
fam5g31
Number of half sisters with cerebral palsy
|
Number of half sisters with cerebral palsy | Family History | |
|
fam5g31_chk
Half sister has cerebral palsy
|
Half sister has cerebral palsy | Family History | |
|
fam5g32
Number of half brothers with cerebral palsy
|
Number of half brothers with cerebral palsy | Family History | |
|
fam5g32_chk
Half brother has cerebral palsy
|
Half brother has cerebral palsy | Family History | |
|
fam5h1
Any siblings with depression?
|
Any siblings with depression? | Family History | |
|
fam5h21
Number of full sisters with depression
|
Number of full sisters with depression | Family History | |
|
fam5h21_chk
Full sister has depression
|
Full sister has depression | Family History | |
|
fam5h22
Number of full brothers with depression
|
Number of full brothers with depression | Family History | |
|
fam5h22_chk
Full brother has depression
|
Full brother has depression | Family History | |
|
fam5h31
Number of half sisters with depression
|
Number of half sisters with depression | Family History | |
|
fam5h31_chk
Half sister has depression
|
Half sister has depression | Family History | |
|
fam5h32
Number of half brothers with depression
|
Number of half brothers with depression | Family History | |
|
fam5h32_chk
Half brother has depression
|
Half brother has depression | Family History | |
|
fam5i1
Any siblings with diabetes?
|
Any siblings with diabetes? | Family History | |
|
fam5i21
Number of full sisters with diabetes
|
Number of full sisters with diabetes | Family History | |
|
fam5i21_chk
Full sister has diabetes
|
Full sister has diabetes | Family History | |
|
fam5i22
Number of full brothers with diabetes
|
Number of full brothers with diabetes | Family History | |
|
fam5i22_chk
Full brother has diabetes
|
Full brother has diabetes | Family History | |
|
fam5i31
Number of half sisters with diabetes
|
Number of half sisters with diabetes | Family History | |
|
fam5i31_chk
Half sister has diabetes
|
Half sister has diabetes | Family History | |
|
fam5i32
Number of half brothers with diabetes
|
Number of half brothers with diabetes | Family History | |
|
fam5i32_chk
Half brother has diabetes
|
Half brother has diabetes | Family History | |
|
fam5j1
Any siblings with an eating disorder?
|
Any siblings with an eating disorder?
This includes anorexia and bulimia |
Family History | |
|
fam5j21
Number of full sisters with an eating disorder
|
Number of full sisters with an eating disorder
This includes anorexia and bulimia |
Family History | |
|
fam5j21_chk
Full sister has eating disorder
|
Full sister has eating disorder
This includes anorexia and bulimia |
Family History | |
|
fam5j22
Number of full brothers with an eating disorder
|
Number of full brothers with an eating disorder
This includes anorexia and bulimia |
Family History | |
|
fam5j22_chk
Full brother has eating disorder
|
Full brother has eating disorder
This includes anorexia and bulimia |
Family History | |
|
fam5j31
Number of half sisters with an eating disorder
|
Number of half sisters with an eating disorder
This includes anorexia and bulimia |
Family History | |
|
fam5j31_chk
Half sister has eating disorder
|
Half sister has eating disorder
This includes anorexia and bulimia |
Family History | |
|
fam5j32
Number of half brothers with an eating disorder
|
Number of half brothers with an eating disorder
This includes anorexia and bulimia |
Family History |