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Adverse Childhood Experiences Questionnaire (ACEs Screening Tool)

These tools were obtained from the ACEs AWARE website. Please see the website for additional language options.


This ACEs Screening Tool for adults (18 years +) was adapted from the work of Kaiser Permanente and the Centers for Disease Control and Prevention. The adult questionnaire was compiled by the Office of the California Surgeon General and Department of Health Care Services in consultation with the  California Surgeon General’s Clinical Advisory Subcommittee. 


Medical providers who will not be providing trauma-focused treatment are recommended to use the de-identified version of this questionnaire.

Provider-Toolkit-ACE-Screening-Tools-Overview (pdf)Download
Provider-Toolkit-Suggested-Clinical-Workflows-for-Screening (pdf)Download
ACE Questionnaire-Adults De-identified English (Recommended) (pdf)Download
ACE-Questionnaire-for-Adults-Identified-English (pdf)Download
ACE-Screener-Deidentified-Spanish (Recommended) (pdf)Download
ACEs-Screener-Identified-Spanish (pdf)Download
Provider-Toolkit-Medi-Cal-Certification-and-Payment (pdf)Download

Adverse Childhood Experiences (ACEs) Questionnaire - Child

These tools were obtained from the ACEs AWARE website. Please see the website for additional language options.

The Pediatric ACEs and Related Life-events Screener (PEARLS) is used to screen children and adolescents ages 0-19 for adverse childhood experiences. PEARLS was developed by the Bay Area Research Consortium on Toxic Stress and Health (BARC), a partnership between the Center for Youth Wellness, the University of California, San Francisco (UCSF), and UCSF Benioff Children’s Hospital Oakland. The PEARLS tool includes an ACEs screening tool (Part 1), plus a screen for additional adversities (Part 2). There are three versions of the tool available, based on age and reporter.

PEARLS-Tool-Child-Parent-Caregiver-Report-De-Identified-English (pdf)Download
PEARLS-Tool-Teen-Parent-Caregiver-Report-De-Identified-English (pdf)Download
PEARLS-Tool-Teen-Self-Report-De-Identified-English (pdf)Download
ChildParentCaregiverReportDeIdentified-Spanish (pdf)Download
TeenParentCaregiverReportDeIdentified-Spanish (pdf)Download
TeenSelfReportDeIdentified-Spanish (pdf)Download
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