Neck Disability Questionnaire

This questionnaire has been designed to give us information as to how your neck pain is affecting your ability to manage in everyday life. Please answer every section, marking only the one box that applies to you. We realise you may consider that two or more statements in any one section relate to you, but please just mark the box that most closely describes your problem.

Name*
MM slash DD slash YYYY
Section 1: Pain Intensity*
Section 2: Personal Care (Washing, Dressing, etc.)*
Section 3: Lifting*
Section 4: Reading*
Section 5: Headaches*
Section 6: Concentration*
Section 7: Work*
Section 8: Driving*
Section 9: Sleeping*
Section 10: Recreation*

NDI developed by: Vernon, H. & Mior, S. (1991). The Neck Disability Index: A study of reliability and validity. Journal of Manipulative and Physiological Therapeutics. 14, 409-415