CDEs
Forms
Are you able to run 100 yards (100 m)?
Are you able to run on even ground?
Are you able to walk up and down two steps?
Are you able to carry a suitcase up a flight of stairs?
Are you able to reach into a low cupboard?
Are you able to climb up 5 flights of stairs?
Are you able to run ten miles (16 km)?
Are you able to walk at a normal speed?
Are you able to stand without losing your balance for several minutes?
Are you able to kneel on the floor?
Are you able to sit down in and stand up from a low, soft couch?
Are you able to open a tight or new jar?
Are you able to do use your hands, such as for turning faucets, using kitchen gadgets, or sewing?
Are you able to sit on and get up from the toilet?
Are you able to transfer from a bed to a chair and back?
Are you able to be out of bed most of the day?
Are you able to carry household items, such as heavy boxes or furniture, up a flight of stairs?
Are you able to water a house plant?
Are you able to wipe yourself after using the toilet?
Are you able to turn from side to side in bed?
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