Please rate your ability to do the following activities in the last week:







During the past week, to what extent has your arm, shoulder or hand problem interfered with your normal social activities with family, friends, neighbours or groups?

During the past week, were you limited in your work or other regular daily activities as a result of your arm, shoulder or hand problem?

Please rate the severity of the following symptoms in the last week:



During the past week, how much difficulty have you had sleeping because of the pain in your arm, shoulder or hand?