This database will store data recorded on the three standardized 4-Digit Code data collection forms:

1. FASD Diagnostic Form: This form guides the interdisciplinary diagnostic team in the collection, recording, and interpretation of all key information used to derive accurate and precise FASD 4-Digit Diagnostic Codes. This form is provided in the Diagnostic Guide for FASD (2004).
   
   
2. New Patient Information Form: This form is sent to families requesting a diagnostic evaluation. The form allows the family to share with the clinic why they are seeking a diagnostic evaluation, what they hope to gain from the evaluation and what they currently know about the patient's exposure(s) and outcomes. This form serves as the clinical intake form. It is provided in the Appendix of the Diagnostic Guide for FASD (2004).
   
   
3. FAS Facial Photographic Analysis Report. This form is generated by the FAS Facial Photographic Analysis Software. It documents all measures recorded from the facial photographs.

The database is designed to print a Diagnostic Outcomes-Patient Profile Summary Report of all patients receiving a 4-Digit Code in your clinic.

This blank database is available free of charge for you to download and use. You are welcome to make alterations to it to customize it to your clinic's needs. To download, click here. Then select "Save" to save it to your computer hard drive. You will receive a zipped version of the database that will require unzipping once it is on your computer hard drive. This database is intended as a template for use by proficient Microsoft Access 2000 (and higher) users. A brief instruction form is provided in the database. There is no technical support available for this database.