We are interested in some things about you and your health. Please answer all of the questions yourself by circling the number that best applies to you. There are no "right" or "wrong" answers. The information that you provide will remain strictly confidential.
Do you have any trouble doing strenuous activities, like carrying a heavy shopping bag or a suitcase?
Do you have any trouble taking a long walk?
Do you have any trouble taking a short walk outside of the house?