PSEQ

  • MM slash DD slash YYYY
  • Please rate how confident you are that you can do the following things at present, despite the pain. To indicate your answer circle one of the numbers on the scale under each item, where 0 = not at all confident and 6 = completely confident.

    Remember, this questionnaire is not asking whether of not you have been doing these things, but rather how confident you are that you can do them at present, despite the pain
  • 0 - Not at all confident123456- Completely confident
  • 0 - Not at all confident123456- Completely confident
  • 0 - Not at all confident123456- Completely confident
  • 0 - Not at all confident123456- Completely confident
  • 0 - Not at all confident123456- Completely confident
  • 0 - Not at all confident123456- Completely confident
  • 0 - Not at all confident123456- Completely confident
  • 0 - Not at all confident123456- Completely confident
  • 0 - Not at all confident123456- Completely confident
  • 0 - Not at all confident123456- Completely confident