Jacqui Allen Questionnaires

Jacqui Allen Questionnaires

Please select the most appropriate response for each question.

Within the last MONTH, how did the following problems affect you?  

0 = no problem and 5 = severe/frequent problem


REFLUX SYMPTOM INDEX
Within the last Month, how did the following problems affect you?
0 = No problem 5 = Severe problem

EATING ASSESSMENT TOOL (EAT-10)
To what extent are the following scenarios problematic for you?
0 = No problem 4 = Severe problem

VOICE HANDICAP INDEX - QUESTIONNAIRE

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