People's problems sometimes affect their ability to do certain day-to-day tasks in their lives. To rate your problems, look at each section and determine on the scale provided how much your problem impairs you ability to carry out the activity.

Question Title

* 1. WORK - If you are retired or choose not to have a job for reasons unrelated to your problem, please tick your answer below:

Question Title

* 2. HOME MANAGEMENT - Cleaning, tidying, shopping, cooking, looking after home/children, playing bills, etc.

Question Title

* 3. SOCIAL LEISURE ACTIVITIES - With other people, e.g. parties, pubs, outings, entertaining, etc

Question Title

* 4. PRIVATE LEISURE ACTIVITIES - Done alone, e.g. reading, gardening, sewing, hobbies, walking, etc

Question Title

* 5. FAMILY AND RELATIONSHIPS - Form and maintain close relationships with others including the people that I live with

0 of 5 answered
 

T