5
Sources
954
Studies
52143
Questions
502
Persons
Did you discuss with your specialist how often you have to come back from this moment on?
Below you see a list of chronic conditions and diseases. Please indicate for each condition or disease whether you have it now or have had it in the past 12 months. Please answer this for each condition or disease.
Please indicate for each condition whether it interferes with your activities or not.
You have indicated that you have had trouble getting (additional) health insurance. What was the outcome?
You have indicated that you have had trouble getting life insurance. What was the outcome?
Instruction: We are interested in certain things about you and your health. Please answer each question by checking the box in the indicated manner. If you are not sure how to answer a question, please give the answer that best applies to your situation. There are no wrong or right answers.
Symptoms or problems. Patients sometimes report that they have the following symptoms or problems. Please indicate the extent to which you have experienced these symptoms or problems during the past week. During the past week:
Anxiety and depression. The following questions are about how you feel right now. Please choose the answer that best describes your current feeling. Do not think too long about your answer. These statements are about your personal impression. There are no wrong answers: it is opinion based.
