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. The most recent version of each form for each study phase is included. 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.

Table of Contents (ES2 forms) - full listing of ES2 English forms, 2010-2020, the PDF images of which can be found below
Extension Study 1 (ES1) forms (2005-2010)
WHI (CT+OS) forms (1993-2005)
Spanish-language forms (all three study phases)
Adjuducations forms (all three study phases)
Form instructions (all three study phases).

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)

Name	Title	Study Phase	Form Type
F009 v8.2	Participation Status	ES2	Form English
F023 v8.2	Search to Locate Participant	ES2	Form English
F024 v8	Retention Worksheet	ES1, ES2	Form English
F033 v13.2	Medical History Update	ES2	Form English
F115 v1	Extension Consent Status	ES2	Form English
F120 v9	Initial Notification of Death	ES2	Form English
F120H v1	Hospitalization Supplement	ES2	Form English
F121 v10 Table 3	Universal Classification of Myocardial Infarction	ES2	Adjudication
F121 v10.1	Report of Cardiovascular Outcome	ES2	Adjudication
F121 v9.2	Report of Cardiovascular Outcome	ES2	Adjudication
F123 v8.2	Report of Fracture Outcome	ES2	Adjudication
F124 v10	Report of Death (Final)	ES2	Form English
F125 v10	Summary of Hospitalization Diagnosis	ES2	Form English
F126 v8.2	Report of VTE	ES2	Adjudication
F130 v9	Report of Cancer	ES2	Adjudication
F132 v9.1	Report of Stroke	ES2	Adjudication
F135 vA	Heart Failure Diagnosis	ES2	Adjudication
F136 vA	Heart Failure Abstraction	ES2	Adjudication
F151 v9.2	Activities of Daily Life	ES2	Form English
F151A v1	Activities of Daily Life	ES2	Form English
F151A v2	Activities of Daily Life	ES2	Form English
F151B v1	Activities of Daily Life	ES2	Form English
F152 v1 ES2	Health Follow-up by Proxy	ES2	Form English
F153 v1	Medication and Supplement Inventory	ES1, ES2	Form English
F155 v1	Lifestyle Questionnaire	ES2	Form English
F156 v1.1	Supplemental Questionnaire 2013-14	ES2	Form English
F157 v1	Supplemental Questionnaire 2014-15	ES2	Form English
F158 v1	Supplemental Questionnaire 2017	ES2	Form English
F159 v1	Supplemental Questionnaire 2018 (data available fall 2019)	ES2	Form English
F190 v1	WHI COVID-19 Survey	ES2	Form English
F191 v1	WHI COVID-19 Survey 2	ES2	Form English
F301 v3	WHI Long Life Study Home Visit	ES2	Form English
F340 v4	LILAC Baseline Questionnaire	ES2	Form English
F370 v2	LILAC Annual Survey	ES2	Form English
F371 v1	LILAC Follow-up Survey	ES2	Form English
F521 v2	Physical Activity Questionnaire	ES2	Form English

Compliance Details

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WHI Forms

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

Forms