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Get Ampac Basic Mobility Outpatient Short Form

Wer to each question. How much DIFFICULTY do you currently have A (If you have not done an activity recently, how much difficulty do you think Unable A Lot Little you would have if you tried?) None 1. Moving from sitting at the side of the bed to lying down on your back? 0 1 2 3 2. Moving up in bed (e.g., reposition self)? 0 1 2 3 3. Standing for at least one minute? 0 1 2 3 4. Sitting down in an armless straight chair (e.g., dining room chair)? 0 1 2 3 5. Standing.

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