12.07.2015 Views

Baseline Questionnaire - GeroNet

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29. How much bodily pain have you had during the past 4weeks?___ None___ Very mild___ Mild___ Moderate___ Severe___ Very severe30. During the past 4 weeks, how much did pain interferewith your normal work (including both work outside the homeand housework)?___ Not at all___ A little bit___ Moderately___ Quite a bit___ ExtremelyPlease choose the answer that best describes how true orfalse each of the following statements is for you.31. I seem to get sick a little easier than other people.___ Definitely true___ Mostly true___ Not sure___ Mostly false___ Definitely false32. I am as healthy as anybody I know.___ Definitely true__ Mostly true___ Not sure___ Mostly false___ Definitely false

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