info@zancenter.com
+923423672974
info@zancenter.com
+923423672974
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Questionnaires
SF-36 Health Survey
Comprehensive Health History Form
PHQ-9 Depression Questionnaire
Perceived Stress Scale (PSS)
International Physical Activity Questionnaire (IPAQ)
PCL-5 (PTSD Checklist)
Food Frequency Questionnaire (FFQ)
Diabetes Distress Scale (DDS)
Simplified FRAX Calculator
Relationship Assessment Scale (RAS)
Chronic Pain Assessment Form
Child Behaviour Checklist (CBCL)
Conflict Resolution Style Questionnaire
Financial Well-Being Scale
Budget Assessment Worksheet
Hot Flushes Rating Questions
Menopause Assessment Form
Pittsburgh Sleep Quality Index (PSQI)
GAD-7 (Generalized Anxiety Disorder-7)
WHO-5 Well-Being Index
WHO Medical Eligibility Tool for Contraceptive Methods
Reproductive Life Planning Tool
International Physical Activity Questionnaire (IPAQ) – Short Form
Values and Priorities Inventory
Cognitive Failures Questionnaire (CFQ)
Everyday Memory Questionnaire (EMQ)
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SF-36 Health Survey
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SF-36 Health Survey
Instructions:
This survey measures your overall health and well-being across several domains. For each question, choose the option that best reflects your experience in the past four weeks.
Section 1: Physical Health
1. In general, would you say your health is:
Excellent
Very Good
Good
Fair
Poor
2. During the past four weeks, how much did your physical health limit you in these activities?
(a) Moderate activities, such as cooking or cleaning:
Not at all
A little
Moderately
Quite a bit
Completely
(b) Lifting or carrying heavy objects:
Not at all
A little
Moderately
Quite a bit
Completely
Section 2: Emotional Well-Being
3. How much of the time during the past four weeks did you feel:
(a) Cheerful and happy?
All the time
Most of the time
Some of the time
Rarely
Never
(b) Calm and peaceful?
All the time
Most of the time
Some of the time
Rarely
Never
4. Have emotional problems affected your daily activities?
Not at all
A little
Some of the time
Moderately
Quite a bit
Extremely
Section 3: Social Functioning
5. How often have you felt your physical or emotional health has limited your social activities (e.g., meeting family or attending events)?
Never
Rarely
Sometimes
Often
Always
6. Do you feel supported by your family or community in dealing with health challenges?
Never
Rarely
Sometimes
Often
Always
Section 4: Energy and Vitality
7. How often during the past four weeks did you feel energetic and full of life?
All the time
Most of the time
Some of the time
Rarely
Never
8. How often did fatigue interfere with your daily life?
Never
Rarely
Sometimes
Often
Always
Scoring and Interpretation of Results:
Excellent Overall Health (Score: 80–100): You’re likely thriving physically, emotionally, and socially. Keep up the good habits!
Moderate Health Concerns (Score: 50–79): You may have occasional challenges that affect your well-being. Consider seeking guidance for specific issues.
Low Health and Well-Being (Score: <50): Persistent health or emotional challenges may need immediate attention. Professional support is recommended.
What’s Next?
If your results indicate moderate to severe issues with your health or well-being, the Zan Center can provide personalized care tailored to Pakistani womens' unique needs, including cultural and social considerations.
Disclaimer: This scale is a general modified guide for Pakistani population. Consult a healthcare provider for a detailed evaluation and treatment.
Submit
Home
Services
Our Specialist Health Clinic
Doctor Mentorship Programme
Life Coaching Service
Financial Coaching Service
Booking
Questionnaires
SF-36 Health Survey
Comprehensive Health History Form
PHQ-9 Depression Questionnaire
Perceived Stress Scale (PSS)
International Physical Activity Questionnaire (IPAQ)
PCL-5 (PTSD Checklist)
Food Frequency Questionnaire (FFQ)
Diabetes Distress Scale (DDS)
Simplified FRAX Calculator
Relationship Assessment Scale (RAS)
Chronic Pain Assessment Form
Child Behaviour Checklist (CBCL)
Conflict Resolution Style Questionnaire
Financial Well-Being Scale
Budget Assessment Worksheet
Hot Flushes Rating Questions
Menopause Assessment Form
Pittsburgh Sleep Quality Index (PSQI)
GAD-7 (Generalized Anxiety Disorder-7)
WHO-5 Well-Being Index
WHO Medical Eligibility Tool for Contraceptive Methods
Reproductive Life Planning Tool
International Physical Activity Questionnaire (IPAQ) – Short Form
Values and Priorities Inventory
Cognitive Failures Questionnaire (CFQ)
Everyday Memory Questionnaire (EMQ)
About Us
FAQs
My Account
Contact Us
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