Forms and documentation

Uniform Data Set (UDS)

v4
v3
v2
v1.2

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, English	Form, Spanish	DED	Data Template
COVID-19 Impact Survey, v1 This optional survey captures data on the impact COVID-19 has had on a participant including testing, course of illness, and medical consequences.
COVID-19 Technology Accessibility Survey, v1 This optional survey captures a participant's preferences regarding remote visits and use of technology.