*This screen is not part of the EQ-5D instrument, it has been added to this demo for information purposes

Welcome to the EQ-5D-3L Device-independent version demo

Would you like to get to know our products better? Please try our EQ-5D Device-independent version demo.You can try this EQ-5D demo on our website without disclosing any personal data. When you try our EQ-5D demo, no scores on the EQ-5D dimensions or any other data will be stored on our servers.

Demo Disclaimer

Health Questionnaire

English version for the UK

Please select the ONE box that best describes your health TODAY.

MOBILITY

I have no problems in walking about

I have some problems in walking about

I am confined to bed

Please select the ONE box that best describes your health TODAY.

SELF-CARE

I have no problems with self-care

I have some problems washing or dressing myself

I am unable to wash or dress myself

Please select the ONE box that best describes your health TODAY.

USUAL ACTIVITIES (e.g. work, study, housework, family or leisure activities)

I have no problems with performing my usual activities

I have some problems with performing my usual activities

I am unable to perform my usual activities

Please select the ONE box that best describes your health TODAY.

PAIN / DISCOMFORT

I have no pain or discomfort

I have moderate pain or discomfort

I have extreme pain or discomfort

Please select the ONE box that best describes your health TODAY.

ANXIETY / DEPRESSION

I am not anxious or depressed

I am moderately anxious or depressed

I am extremely anxious or depressed

We would like to know how good or bad your health is TODAY.
You will see a scale numbered from 0 to 100.
100 means the best health you can imagine.
0 means the worst health you can imagine.
Please indicate on the scale how your health is TODAY.

YOUR HEALTH TODAY =

*This screen is not part of the EQ-5D instrument, it has been added to this demo for information purposes

You have now completed this questionnaire.

If you would like to change any of your answers, you may do so by pressing the "Previous" button prior to finalizing the questionnaire.

Please finalize the questionnaire by pressing the ”Finalize" button. Once you press ”Finalize", you will not be able to go back to review or change your answers.

*This screen is not part of the EQ-5D instrument, it has been added to this demo for information purposes

Thank you for completing EQ-5D