| 112462-7 | Did you feel that you didn't have enough to eat, had to wear dirty clothes, or had no one to protect or take care of you:Find:RptPeriod:^Patient:Ord: | required |
| 112461-9 | Did you lose a parent through divorce, abandonment, death, or other reason:Find:RptPeriod:^Patient:Ord: | required |
| 112459-3 | Did you live with anyone who was depressed, mentally ill, or attempted suicide:Find:RptPeriod:^Patient:Ord: | required |
| 112457-7 | Did you live with anyone who had a problem with drinking or using drugs, including prescription drugs:Find:RptPeriod:^Patient:Ord: | required |
| 112455-1 | Did your parents or adults in your home ever hit, punch, beat, or threaten to harm each other:Find:RptPeriod:^Patient:Ord: | required |
| 112453-6 | Did you live with anyone who went to jail or prison:Find:RptPeriod:^Patient:Ord: | required |
| 112452-8 | Did a parent or adult in your home ever swear at you, insult you, or put you down:Find:RptPeriod:^Patient:Ord: | |
| 112451-0 | Did a parent or adult in your home ever hit, beat, kick, or physically hurt you in any way:Find:RptPeriod:^Patient:Ord: | required |
| 112445-2 | Did you feel that no one in your family loved you or thought you were special:Find:RptPeriod:^Patient:Ord: | required |
| 112444-5 | Did you experience unwanted sexual contact:Find:RptPeriod:^Patient:Ord: | required |
| 112442-9 | Total score:Score:RptPeriod:^Patient:Qn:ACE Questionnaire for Adults | required |
| 112443-7 | Do you believe that these experiences have affected your health:Find:RptPeriod:^Patient:Ord: | required |
| 112441-1 | Adverse Childhood Experience Questionnaire for Adults:-:RptPeriod:^Patient:-:ACE Questionnaire for Adults | |