Roland Morris Questionnaire

When your back hurts, you may find it difficult to do some of the things you normally do.

This list contains some sentences that people have used to describe themselves when they have back pain. When you read them, you may find that some stand out because they describe you today. As you read the list, think of yourself today. When you read a sentence that describes you today, check the box. If the sentence does not describe you, then leave the box unchecked and go on to the next one.

Remember only check the box of the sentence if you are sure that it describes you today.