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To what extent do you find it problematic to carry out the activities listed below because of pelvic girdle pain - cardiffandvaleuhb wales nhs 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your name and the date at the top of the form. This personal information is essential for tracking your responses.
  3. For each activity listed, assess how problematic it is for you due to pelvic girdle pain. Tick the box that best describes your current experience, ranging from 'Not at all' to 'To a large extent'.
  4. If any activities are not applicable to you, write 'N/A' in the appropriate row to ensure clarity in your responses.
  5. Next, indicate your pain levels during morning and evening by selecting the corresponding options provided.
  6. Finally, answer questions regarding how pelvic girdle pain affects your daily activities and sleep patterns by ticking the relevant boxes.

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