Unique ID | Unique ID (from research team) | Â | Code 1 |
---|---|---|---|
Survey access code | Consent and baseline survey access code | Â | Access code 1 |
Family | Siblings had teeth removed under GA | Yes/no | Â |
Universal partnership/universal partnership plus classification | UP/UPP | Â | |
Reason for classification | If you do not feel it is appropriate to share please write that here too | Â | |
Oral health pack | Given | Yes/no | Â |
Method | Home visit/clinic/posted | Â | |
Accepted | Yes/no | Â | |
If not, reason | Â | Â | |
Consent | Participant gave consent | Yes/no | Â |
Signed consent electronically or on paper | Electronic/paper | Â | |
Baseline questionnaire | Completed questionnaire | Yes/no | Â |
Electronic or paper | Electronic/paper | Â | |
Date completed | dd/mm/yyyy | Â | |
Time | (if possible or rough time, AM or PM) | Â | |
For paper based: family/ health visitor will post consent and questionnaire | Family/HV | Â | |
Expected follow-up date | Expected follow-up date | dd/mm/yyyy | Â |
Follow-up questionnaire | First contact | Reached/did not reach | Â |
Second contact | Reached/did not reach | Â | |
Third contact | Reached/did not reach | Â | |
Completed on call | Yes/no | Â | |
Completion date | dd/mm/yyyy | Â | |
Link sent | Yes/ No | Â |