Document Name and Accession

Document Name: CREST-E UNIFIED HUNTINGTON'S DISEASE RATING SCALE '99 (TFC)
Document Accession: phd007409.1

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CREST-E UNIFIED HUNTINGTON'S DISEASE RATING SCALE '99 (TFC)

(10/4/07) 10/31/08

116 | 30

SUBJECT ID VISIT NO
INITIALS SITE NO VISIT DATE MM DD YYYY

VI. FUNCTIONAL CAPACITY
Link to associated variable70. OCCUPATION
0 = unable
1 = marginal work only
2 = reduced capacity for usual job
3 = normal
Link to associated variable71. FINANCES
0 = unable1 = major assistance2 = slight assistance3 = normal
Link to associated variable72. DOMESTIC CHORES
0 = unable1 = impaired2 = normal
Link to associated variable73. ADL
0 = total care
1 = gross tasks only
2 = minimal impairment
3 = normal
Link to associated variable74. CARE LEVEL
0 = full time skilled nursing1 = home or chronic care2 = home
INFORMATIONAL SOURCES
Link to associated variable75. Was the Functional Capacity information obtained from:
1 = Subject only2 = Subject and family/companion
76. Functional Examiner STAFF CODE