CDEs
Forms
Does your health now limit you in climbing one flight of stairs?
Does your health now limit you in getting in and out of the bathtub?
Does your health now limit you in walking about the house?
How much difficulty do you have doing your daily physical activities, because of your health?
To what extent are you able to carry out your everyday physical activities such as walking, climbing stairs, carrying groceries, or moving a chair?
In the past 7 days how often did you feel run-down?
In the past 7 days how often did you experience extreme exhaustion?
In the past 7 days how often did you feel tired even when you hadn't done anything?
In the past 7 days how often did you feel your fatigue was beyond your control?
In the past 7 days how often were you sluggish?
In the past 7 days how often did you run out of energy?
In the past 7 days how often were you physically drained?
In the past 7 days how often did you feel tired?
In the past 7 days how often were you bothered by your fatigue?
In the past 7 days how often did you have enough energy to enjoy the things you do for fun?
In the past 7 days how often were you too tired to enjoy life?
In the past 7 days how often were you too tired to feel happy?
In the past 7 days how often did you feel totally drained?
In the past 7 days how often were you energetic?
In the past 7 days how often did you find yourself getting tired easily?
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