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The Functional Status Questionnaire provides a self-assessment method to evaluate a user's physical, psychological, social, and role functions. This guide will walk you through each section, ensuring you can complete the form accurately and effectively.

Follow the steps to successfully fill out the form.

1. Press the 'Get Form' button to access the questionnaire and open it in your preferred document editor.
2. Begin with the first section, 'Physical Function (Activities of Daily Living).' Read each question carefully, and for each activity listed, select the response that best describes your experience within the past month. Use the provided point system to record your responses.
3. Next, move to the 'Psychological Function' section. Answer the questions by indicating how often you felt that way over the past month and assign the corresponding points based on your responses.
4. Continue to the 'Role Function' section. This part will have questions related to your work performance and how your health may have impacted your job duties. Carefully respond to each question and record your points.
5. After completing the role function section, proceed to the 'Social Function' section. Here, assess your interactions and participation in social activities. Circle the responses that best reflect your situation, and note the corresponding scores.
6. Finally, fill out the 'Single Item Questions' at the end of the questionnaire. For each statement, choose the option that best describes your experience and record your answers.
7. After completing all sections, review your answers for accuracy. Once satisfied, you can save your changes, download a copy of the completed questionnaire, print it for your records, or share it as needed.

Complete your Functional Status Questionnaire online today for an insightful assessment of your well-being.