Osteoarthritis Survey

Please answer all questions as accurately as possible. Your responses are confidential.

Demographics

Gender

male

female

Age

Occupation

Current occupation or the one you held for the longest period

office work

hard manual labor

housewife

outdoor work

light to moderate activity

Medical History

Have you been diagnosed with osteoarthritis by a doctor?

yes

no

unsure

Affected Joints

Select all that apply.

knee

hip

hand

shoulder

spine

Do you experience joint pain or stiffness lasting more than 3 months?

yes

no

unsure

Activity

Your usual physical activity level

sedentary

lightly active

moderately active

very active