SF - 36 Health Survey


Phoenix Rising Founder
Arizona in winter & W. North America otherwise
The Medical Outcomes Study SF-36 Health Survey (Short Form) For Your View Pleasure Only

Instructions: This survey asks for your views about your health. This information will help keep track of how you feel and how well you are able to do your usual activities.

Answer every question by marking the answer as indicated. If you are unsure about how to answer a question, please give the best answer you can.
1. During the past 4 weeks, to what extent has your physical health or emotional problems interfered with your normal social activities with family, neighbors, or groups? (Please check one)

 Not at all
 Slightly
 Moderately
 Quite a bit
 Extremely

2. During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting with friends, relatives, etc.)? (Please check one)

 All of the time
 Most of the time
 Some of the time
 A little of the time
 None of the time

During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of your physical health? Yes No

3a. Cut down on the amount of time you spent on work or other activities 1 2
3b. Accomplished less than you would like 1 2
3c. Were limited in the kind of work or other activities 1 2
3d. Had difficulty performing the work or other activities (For example, it took extra effort) 1 2

These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling.

How much of the time during the past 4 weeks All of the Time Most of the Time A Good Bit of the Time Some of the Time A Little of the Time None of the Time

4a. Did you feel full of pep? 1 2 3 4 5 6
4b. Did you have a lot of energy? 1 2 3 4 5 6
4c. Did you feel worn out? 1 2 3 4 5 6
4d. Did you feel tired? 1 2 3 4 5 6


Senior Member
This survey is a bit rubbish for CFS patients. This is really a commonly used list of questions? So much depends upon how you interpret their use of language. I've no idea how I'd answer most of the Qs. I have no suggestions for improvement - I think we could drop this whole section.