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EZFC Form #1

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Oxford Shoulder Score

Each question refers to your symptoms during the Last 4 weeks. All fields are required.

None
Mild
Moderate
Severe
Unbearable
None
Very mild
Mild
Moderate
Severe
Not at all
A little bit
Moderately
Greatly
Totally
No nights
Only 1 or 2 nights
Some nights
Most nights
Every nights
No trouble
Little trouble
Moderate trouble
Extreme difficulty
Impossible to do
No trouble
Little trouble
Moderate trouble
Extreme difficulty
Impossible to do
Yes, easily
With little difficulty
With moderate difficulty
With extreme difficulty
No, impossible
Yes, easily
With little difficulty
With moderate difficulty
With extreme difficulty
No, impossible
Yes, easily
With little difficulty
With moderate difficulty
With extreme difficulty
No, impossible
Yes, easily
With little difficulty
With moderate difficulty
With extreme difficulty
No, impossible
Yes, easily
With little difficulty
With moderate difficulty
With extreme difficulty
No, impossible
Yes, easily
With little difficulty
With moderate difficulty
With extreme difficulty
No, impossible

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