Key facts
- Score direction
- Higher is better
- Time to complete
- 3 min
- Questions
- 1
- Licensing
- Available free of charge; Patient Watch charges only for platform services
Anatomic Areas
Clinical Indications
Administration Instructions
Please watch the full video and confirm completion.
Related Outcome Measures
Other clinical questionnaires for similar specialties and conditions
Address
Captures the patient postal address.
Adverse event report
Allows patients to report a possible adverse event related to their treatment in free text.
Body Mass Index (BMI)
Records height and weight with the patient's preferred units and calculates body mass index.
Fatigue (NRS 0-10) and Comments
Allows patients to record fatigue severity on a 0-10 numerical rating scale and provide additional comments.
MS Activities of Daily Living
Choose up to 3 important activities of daily living from a predefined list, then rate your current difficulty with each (0 = no difficulty, 10 = unable to perform).
Visual Analogue Score and Comments
Allows patients to record pain levels and provide additional comments.
This questionnaire is provided free of charge. Patient Watch charges only for platform services (data storage, automated reminders, analytics) - not for use of clinical instruments. This non-commercial model supports academic and clinical use.View full licensing disclosure