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EORTC QLQ-LC13

Patients sometimes report that they have the following symptoms or problems. Please indicate the extent to which you have experienced these symptoms or problems during the past week. Please answer by selecting the response that best applies to you.

Please select a response

QUESTION: 1

During the past week:

Please provide a response

QUESTION: 12

If yes, where?

Have you had pain in other parts of your body?

During the past week:

You’ve answered all the questions for the EORTC QLQ-LC13 Questionnaire.

If you would like to go back and edit your responses, tap Edit. Otherwise tap Save to proceed and save your responses.

Thank you for completing the questionnaire!

NCI-PRO-CTCAE™ ITEMS-ENGLISH

As individuals go through treatment for their cancer they sometimes experience different symptoms and side effects. For each question, please select the one response that best describes your experiences over the past 7 days…

QUESTION: # OF 8

Please select a response

Thank you for completing the questionnaire!

NCI-PRO-CTCAE™ ITEMS-ENGLISH

As individuals go through treatment for their cancer they sometimes experience different symptoms and side effects. For each question, please select the one response that best describes your experiences over the past 7 days…

QUESTION:

Please select a response

Thank you for completing the questionnaire!

QUESTION:

Please select a response

QUESTION:

QUESTION:

Please select a response

QUESTION:

Very Poor

Excellent

You’ve answered all the questions for the EORTC QLQ-C30 Questionnaire.

If you would like to go back and edit your responses, tap Edit. Otherwise tap Save to proceed and save your responses.Label

Health Questionnaire English version for the UK

© EuroQol Research Foundation. EQ-5D™ is a trade mark 
of the EuroQol Research Foundation

© EuroQol Research Foundation. EQ-5D™ is a trade mark 
of the EuroQol Research Foundation

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© EuroQol Research Foundation. EQ-5D™ is a trade mark
of the EuroQol Research Foundation

Please tap on the scale to indicate how your health is today.

The best health you can imagine

The worst health you can imagine

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© EuroQol Research Foundation. EQ-5D™ is a trade mark 
of the EuroQol Research Foundation

You’ve answered all the questions for the EQ-5D-5L Questionnaire.

If you would like to go back and edit your responses, tap Edit. Otherwise tap Save to proceed and save your responses.

Thank you for completeting the questionnaire!

EQ-5D-5L

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Question 1: What is your high school graduation year?