Dartmouth COOP Functional Assessment Charts - 4 weeks

Label	Value	Unit
During the past 4Ws, what was the hardest physical activity you could do for at least 2 minutes:Score:4W:^Patient:Ord:COOP ©		{score}
During the past 4Ws, how much have you been bothered by emotional problems such as feeling anxious, depressed, irritable or downhearted and blue:Score:4W:^Patient:Ord:COOP ©		{score}
During the past 4Ws, how much difficulty have you had doing your usual activities or tasks, both inside and outside the house because of your physical and emotional health:Score:4W:^Patient:Ord:COOP ©		{score}
During the past 4Ws, has your physical and emotional health limited your social activities with family, friends, neighbors or groups:Score:4W:^Patient:Ord:COOP ©		{score}
During the past 4Ws, how much bodily pain have you generally had:Score:4W:^Patient:Ord:COOP ©		{score}
How would you rate your overall health now compared to 4Ws ago:Score:Pt:^Patient:Ord:COOP ©		{score}
During the past 4Ws, how would you rate your health in general:Score:4W:^Patient:Ord:COOP ©		{score}
During the past 4Ws, was someone available to help you if you needed and wanted help:Score:4W:^Patient:Ord:COOP ©		{score}
How have things been going for you during the past 4Ws:Score:4W:^Patient:Ord:COOP ©		{score}
Total score:Score:Pt:^Patient:Qn:COOP ? ©		{score}