Eq 5d questionnaire pdf 2026

1. Click ‘Get Form’ to open the EQ-5D-5L Health Questionnaire in the editor.
2. Begin by entering your Patient Name and Account Number at the top of the form. This personal information is essential for tracking your responses.
3. In the Mobility section, select one statement that best describes your walking ability today by placing a checkmark in the corresponding box.
4. Proceed to the Self-Care section and indicate your ability to wash or dress yourself using a similar checkmark method.
5. Next, move to Usual Activities. Choose one option that reflects your capability to perform daily tasks like work or leisure activities.
6. In the Pain/Discomfort section, mark the statement that aligns with your current pain level.
7. Finally, assess your Anxiety/Depression state and select the appropriate response.
8. Complete both sides of the form by marking an X on the health scale provided, then write down the number you marked in the designated box below.

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