ReQol

Please complete the following if you have been asked to do so

4 = None of the time 3=Only occasionally 2= Sometimes 1=Often 0= Most or all of the time
0 = None of the time 1=Only occasionally 2= Sometimes 3=Often 4= Most or all of the time
4 = None of the time 3=Only occasionally 2= Sometimes 1=Often 0= Most or all of the time
0 = None of the time 1=Only occasionally 2= Sometimes 3=Often 4= Most or all of the time
0 = None of the time 1=Only occasionally 2= Sometimes 3=Often 4= Most or all of the time
4 = None of the time 3=Only occasionally 2= Sometimes 1=Often 0= Most or all of the time
4 = None of the time 3=Only occasionally 2= Sometimes 1=Often 0= Most or all of the time
4 = None of the time 3=Only occasionally 2= Sometimes 1=Often 0= Most or all of the time
4 = None of the time 3=Only occasionally 2= Sometimes 1=Often 0= Most or all of the time
4 = None of the time 3=Only occasionally 2= Sometimes 1=Often 0= Most or all of the time
4 No problems 3 Slight problems 2 Moderate problems 1 Severe problems 0 Very severe problems