Ped-PRO-CTCAE/Ped-PRO-CTCAE [Caregiver] Instrument & Form Builder

Pediatric PRO-CTCAE^®/Pediatric PRO-CTCAE^® [Caregiver]

Use of Ped-PRO-CTCAE^® and Pediatric PRO-CTCAE^® [Caregiver] are subject to NCI's Terms of Use. Preview the symptom terms included in the Ped-PRO-CTCAE Item Library using the quick guide. You may download the full instrument for reporting by children ages 7-17 (Ped-PRO-CTCAE) or the full instrument for reporting by a caregiver for children ages 7-17 who are unable to self-report (Ped-PRO-CTCAE [Caregiver]). You may also use our Form Builder to produce a customized Ped-PRO-CTCAE or Ped-PRO-CTCAE [Caregiver] survey for your study. Form Builder is quick, easy to use, and eliminates the potential for cutting and pasting errors.

Form Builder

Use Form Builder to generate a custom built form for your study.

Full Ped-PRO-CTCAE Libraries

English
- English [Child 7–17 years] (PDF, 1.4 MB)
- English [Caregiver] (PDF, 1.5 MB)
Chinese (Simplified)
- Simplified Chinese [Child 7–17 years] (PDF, 539 KB)
- Simplified Chinese [Caregiver] (PDF, 553 KB)
Italian
- Italian [Child 7–17 years] (PDF, 371 KB)
- Italian [Caregiver] (PDF, 381 KB)
Spanish
- Spanish [Child 7–17 years] (PDF, 362 KB)
- Spanish [Caregiver] (PDF, 363 KB)

Section 508 compliance: The English version of the full instrument is accessible to assistive technologies, but translated versions may not be. If you have difficulty reading the instrument, contact us or use HHS Language Assistance Services .