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Pre-appointment Questions for Prof Vancaillie

K10 Test

These questions concern how you have been feeling over the past 30 days. Answer each question via by choosing the answer that best represents how you have been. 
1.Mark a circle next to each question that best represents how you have been.
None of the time
A little of the time
Some of the time
Most of the time
All of the time
1. During the last 30 days, about how often did you feel tired out for no good reason?
2. During the last 30 days, about how often did you feel nervous?
3. During the last 30 days, about how often did you feel so nervous that nothing could calm you down?
4. During the last 30 days, about how often did you feel hopeless?
5. During the last 30 days, about how often did you feel restless or fidgety?
6. During the last 30 days, about how often did you feel so restless you could not sit still?
7. During the last 30 days, about how often did you feel depressed?
8. During the last 30 days, about how often did you feel that everything was an effort?
9. During the last 30 days, about how often did you feel that nothing could cheer you up?
10. During the last 30 days, about how often did you feel worthless?
2.Please enter your contact information to add to your file for your upcoming appointment