Very important Somewhat important Not very important Not ...

[Pages:4]PERSONAL PREFERENCE

Very important Somewhat important Not very important Not important at all Important, but can't do or no choice No response or non-responsive

Provided by QIPMO, MU MDS and Quality Research Team

April 2010

PHQ-9

Never or 1 day 2-6 days (several days) 7-11 days (half or more of the days) 12-14 days (nearly every day)

Provided by QIPMO, MU MDS and Quality Research Team

April 2010

PAIN

10 Worst pain you can imagine 9 8 7 6 5 4 3 2 1

0 No pain

Provided by QIPMO, MU MDS and Quality Research Team

April 2010

PAIN

Very severe, horrible Severe

Moderate Mild

Provided by QIPMO, MU MDS and Quality Research Team

April 2010

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