WORK MODULE (OPTIONAL)

The following questions ask about the impact of your arm, shoulder or hand problem on your ability to work (including homemaking if that is your main work role).
Please indicate what your job/work is: _ _  _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Please select only one answer that best describes your physical ability in the past week.

It is important you ick only one box per question

Did you have any difficulty:

1. using your usual technique for your work?

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

2. doing your usual work because of arm, shoulder or hand pain?

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

3. doing your work as well as you would like?

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

4. spending your usual amount of time doing your work?

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

Your QuickDASH work total is: