MS Activities of Daily Living

Choose up to 3 important activities of daily living from a predefined list, then rate your current difficulty with each (0 = no difficulty, 10 = unable to perform).

Instructions:

On your first visit, select 1 to 3 activities of daily living from the list below that are important to you. Rate your current difficulty with each from 0 (no difficulty) to 10 (unable to perform). On later visits you will only re-rate the same activities.

Choose your activities of daily living

Which activities of daily living are important to you?

Type: ms-adl-selection

Choose the daily living activities you want to track over time.

Rate ADL difficulty

Rate your difficulty with each activity of daily living

Type: ms-adl-ratings-list

0 = no difficulty · 10 = unable to perform

Patient Watch Form - 7/31/2026