Printable version of the mRS-9Q

Question 1: Do you have any symptoms that are bothering you?

YES
NO

Question 2: Are you able to do the same work as before?

YES
NO

Question 3: Are you able to keep up with your hobbies?

YES
NO

Question 4: Have you maintained your ties to friends and family?

YES
NO

Question 5: Do you need help making a simple meal, doing household chores, or balancing a checkbook?

YES
NO

Question 6: Do you need help with shopping or traveling close to home?

YES
NO

Question 7: Do you need another person to help you walk?

YES
NO

Question 8: Do you need help with eating, going to the toilet, or bathing?

YES
NO

Question 9: Do you stay in bed most of the day and need constant nursing care?

YES
NO

The mRS-9Q Survey by Alexander C. Flint, M.D., Ph.D. is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License.
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As of 2015, the mRS-9Q is being used in 134 countries across the world:

mRS-9Q Map