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These are the surveys the California Teachers Study has sent since 1995. These are provided for informational use only. Please don’t copy, distribute, or otherwise use these forms without express permission from the California Teachers Study. NOTE: These versions of the surveys are non-scannable, and cannot be processed on our scanning equipment. If you’re a CTS member, please only complete surveys you receive in the mail. Adobe Acrobat® Reader can be used to view the surveys. Click Here to download it now.

QUESTIONNAIRE 5
Our fifth survey is a comprehensive update of women’s health history, especially factors that may be related to breast cancer. We explore sleep habits, oral contraceptive and hormone use, physical activities, vitamin supplements, hormone patches/creams, personal care practices, diabetes and the use of various kinds of medications. We are also asking our study members whether their children have diabetes. Mailing of this began in July 2012.

QUESTIONNAIRE 4
Our fourth survey was first mailed November 2005. It collects a comprehensive update of women’s health history especially factors that may be related to breast cancer, such as exercise, diet, vitamin supplements, smoking and pregnancy and the use of various kinds of medications and menopausal hormone therapy. We also asked about other conditions that study members may have had such as diabetes, asthma, endometriosis, and mastitis.

QUESTIONNAIRE 3
The third survey was mailed in 2000/2001. This questionnaire focused on perception of stress, social support, and cognition.

QUESTIONNAIRE 2
The second questionnaire was sent in 1997/1998, focusing on exposure to secondhand smoke and medical radiation (x-rays). It also included self-measurement of waist and hip circumferences.

QUESTIONNAIRE 1
This baseline questionnaire was first sent out in October 1995 and focused on potential breast cancer risk factors including a comprehensive assessment of diet, alcohol use, use of hormone therapy and oral contraceptives, physical activity, menstrual and reproductive factors, family history of cancer and other diseases, exposure to electromagnetic fields, and smoking. 133,479 women responded to this questionnaire.

 

 

 

 

 

 

 

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