Neck Disability Index
Plexus Physical Therapy - Status Questionnaires

Please complete the following questionnaire to help us track your progress and identify how to best help you!

This questionnaire has been designed to give us information as to how your neck pain has affected your ability to manage in everyday life. Please answer every section and mark in each section only the one box that applies to you. We realise you may consider that two or more statements in any one section relate to you, but please just mark the box that most closely describes your problem.

Name
Your answer
Date
MM
/
DD
/
YYYY
Pain intensity
Personal care (washing, dressing, etc)
Lifting
Reading
Headaches
Concentration
Work
Driving
Sleeping
Recreation
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