Please read each statement and select a number 0, 1, 2 or 3 which indicates how much the statement applied to you over the past week. There are no right or wrong answers.
Do not spend too much time on any one statement. This assessment is not intended to be a diagnosis. If you are concerned about your results in any way, please speak with a qualified health professional.
0 = Did not apply to me at all
1 = Applied to me to some degree or for some of the time
2 = Applied to me to a considerable degree or for a good part of time
3 = Applied to me very much or most of the time
The results you will be provided with at the end of the test, are intended as a guide to your health and are presented for educational purposes only. They are not intended to be a clinical diagnosis. If you are concerned in any way about your health, please consult with a qualified health professional or us.