LHC-Forms Demo

This form is complete.

Display Question Code

Show Help/Description

Keyboard Navigation On Input Fields

Total # of Questions: 15

PROMIS item bank - social isolation - version 2.0 [76806-9]

Date Done

Time Done

Where Done

Comment

Name

Value

Units

People get the wrong idea about my situation [76883-8]

I feel isolated even when I am not alone [76757-4]

I feel that people avoid talking to me [76758-2]

I feel detached from other people [76759-0]

I feel that some of my friends avoid me [76884-6]

I feel that some of my family members avoid me [76885-3]

I feel that I am alone in my interests and ideas [76887-9]

I feel that people barely know me [76762-4]

I feel like a stranger to those around me [76760-8]

I find that friends or relatives have difficulty talking with me about my health [76882-0]

I feel that people are around me but not with me [76764-0]

I feel isolated from others [76763-2]

I feel left out [76761-6]

I feel that I am no longer close to anyone [76886-1]

PROMIS social isolation - version 2.0 T-score [77849-8]

PLEASE WAIT