PROMIS Global 10

PROMIS Global 10 Generic Health Questionnaire

20% of survey complete.

Question Title

* Please respond to each item by marking one box per row

	Excellent	Very Good	Good	Fair	Poor
In general, would you say your health is:	In general, would you say your health is: Excellent	In general, would you say your health is: Very Good	In general, would you say your health is: Good	In general, would you say your health is: Fair	In general, would you say your health is: Poor
In general, would you say your quality of life is:	In general, would you say your quality of life is: Excellent	In general, would you say your quality of life is: Very Good	In general, would you say your quality of life is: Good	In general, would you say your quality of life is: Fair	In general, would you say your quality of life is: Poor
In general, how would you rate your physical health?	In general, how would you rate your physical health? Excellent	In general, how would you rate your physical health? Very Good	In general, how would you rate your physical health? Good	In general, how would you rate your physical health? Fair	In general, how would you rate your physical health? Poor
In general, how would you rate your mental health, including your mood and your ability to think?	In general, how would you rate your mental health, including your mood and your ability to think? Excellent	In general, how would you rate your mental health, including your mood and your ability to think? Very Good	In general, how would you rate your mental health, including your mood and your ability to think? Good	In general, how would you rate your mental health, including your mood and your ability to think? Fair	In general, how would you rate your mental health, including your mood and your ability to think? Poor
In general, how would you rate your satisfaction with your social activities and relationships?	In general, how would you rate your satisfaction with your social activities and relationships? Excellent	In general, how would you rate your satisfaction with your social activities and relationships? Very Good	In general, how would you rate your satisfaction with your social activities and relationships? Good	In general, how would you rate your satisfaction with your social activities and relationships? Fair	In general, how would you rate your satisfaction with your social activities and relationships? Poor
In general, please rate how well you carry out your usual social activities and roles. (This includes activities at home, at work and in your community, and responsibilities as a parent, child, spouse, employee, friend, etc.)	In general, please rate how well you carry out your usual social activities and roles. (This includes activities at home, at work and in your community, and responsibilities as a parent, child, spouse, employee, friend, etc.) Excellent	In general, please rate how well you carry out your usual social activities and roles. (This includes activities at home, at work and in your community, and responsibilities as a parent, child, spouse, employee, friend, etc.) Very Good	In general, please rate how well you carry out your usual social activities and roles. (This includes activities at home, at work and in your community, and responsibilities as a parent, child, spouse, employee, friend, etc.) Good	In general, please rate how well you carry out your usual social activities and roles. (This includes activities at home, at work and in your community, and responsibilities as a parent, child, spouse, employee, friend, etc.) Fair	In general, please rate how well you carry out your usual social activities and roles. (This includes activities at home, at work and in your community, and responsibilities as a parent, child, spouse, employee, friend, etc.) Poor