Example Working EQ5D+3 Survey Questionnaire

Cancer Quality of Life Questionnaire
Help us understand what we are doing right, what needs improving and anything else you would like to tell us

This is a fully functional survey e-questionnaire so you can try it out for completion. However, we do not analyse the results of this example survey
1.Which best describes your health today regarding your: MOBILITY
2.Which best describes your health today regarding: SELF-CARE
3.Which best describes your health today regarding: USUAL ACTIVITIES (e.g. work, study, housework, family, or leisure activities)
4.Which best describes your health today regarding : PAIN/DISCOMFORT
5.Which best describes your health today regarding : ANXIETY/DEPRESSION