Data form

For each item below click on the line to show your current status from worst to best possible

Please answer all questions based only on the previous 24 hours
Feeling of general well-being Very Poor Excellent
Presence and severity of bodily pain Extreme No Problem
Feeling washed out or drained Full of Energy Extremely Fatigued
Sleep quality Very Poor Excellent
Difficulty breathing or shortness of breath Extreme No Problem
Appetite Excellent Very Poor
Concentration Very Poor Excellent
Have you drunk any alcohol in the last 24 hours ? Yes No
Compared to normal my alcohol intake has been Much more Much less