This questionnaire has been designed to give the doctor information as to how your neck pain has affected your ability to manage in everyday life. Please answer every section and mark in each section only the ONE box which applies to you. We realize you may consider that two of the statements in any one section relate to you, but please just mark the box which most closely describes your problem.
0-4 No disability
5-14 Mild disability
15-24 Moderate disability
25-34 Severe disability
> 35 Complete disability
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