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DSQ Scanning Information: Westat

Westat, Inc.External Web Site Policy provides scanning and intelligent data capture for the Dietary Screener Questionnaire (DSQ). Services include providing printed questionnaires for data collection and processing completed questionnaires. Westat can provide a modified version of the DSQ for customized data collections. A verified data file along with images of the processed DSQ questionnaires are provided after processing.

Information on ordering questionnaires, scanning and verification, and data file delivery is provided below.

Requirements & Cost

Order Questionnaires from Westat

To order DSQ forms from Westat, send an e-mail to Please provide your name, telephone number, organization, address, and number of forms needed.

The cost of 200 booklets (black ink on white paper) is $100. If you prefer color or other options, please contact for additional pricing information.

Process Completed Surveys at Westat

Please contact Forms Processing when you are ready to set up processing for completed surveys. Mail completed surveys to:

DSQ Processing, RC B16
1600 Research Blvd
Rockville, MD 20850-9973
Attention: Beth Hunter

Scanning & Processing the Questionnaire

When Westat receives the questionnaires, they will be processed according to the schedule agreed upon when the processing arrangements were made.

The cost of processing 200 forms is $100. Cost estimates will be provided upon request for other processing quantities or special requests.

A data file and image file of the questionnaires will be provided following processing. A codebook is included with the DSQ download form.

Modify the Questionnaire

Modifications can be incorporated, including special identification numbers, barcodes, new questions, color printing, graphics, and logos upon request. Please contact to request creation of a modified questionnaire. A cost estimate can be provided for modifications to the questionnaire and codebook. Estimated costs generally range from $25 to $200.

DSQ Form to Download

The DSQ questionnaire PDF and codebook are available for download below. Information on ordering questionnaires and making processing arrangements are provided above. Forms may be downloaded for data collection if printed clearly on 8 ½ x 11 paper and used with unique identifiers in the spaces provided on all pages. Note that if forms are not printed at Westat with unique identifiers and accurate page sizing, there may be additional processing costs for special handling.

Last Modified: 11 Apr 2014