Wellbeing (Please delete this domain heading which is for administration use only) are some statements about feelings and thoughts. Please circle the number that best describes your experience of each over the last 2 weeks. None of Rarely Some of Often All of the the time the time time I’ve been feeling optimistic 1 2 3 4 5 about the future I’ve been feeling useful 1 2 3 4 5 I’ve been feeling relaxed 1 2 3 4 5 I’ve been dealing with 1 2 3 4 5 problems well I’ve been thinking clearly 1 2 3 4 5 I’ve been feeling to 1 2 3 4 5 other people I’ve been able to make up 1 2 3 4 5 my own mind about things Health (Please delete this domain heading which is for administration use only) By placing a tick in one box in each group below, please indicate which statements best describe your own health state today. Mobility: I have no problems in walking about I have some problems in walking about
Wellbeing (Please delete this domain heading which is for administration use only) are some statements about feelings and thoughts. Please circle the number that best describes your experience of each over the last 2 weeks. None of the time Rarely Some of the time Often All of the time I’ve been feeling optimistic about the future 1 2 3 4 5 I’ve been feeling useful 1 2 3 4 5 I’ve been feeling relaxed 1 2 3 4 5 I’ve been dealing with problems well 1 2 3 4 5 I’ve been thinking clearly 1 2 3 4 5 I’ve been feeling to other people 1 2 3 4 5 I’ve been able to make up my own mind about things 1 2 3 4 5 Health (Please delete this domain heading which is for administration use only) By placing a tick in one box in each group below, please indicate which statements best describe your own health state today. Mobility: I have no problems in walking about I have some problems in walking about
cmf_toolkit_5.1.docx