The Roland Morris Disability Questionnaire (below) is a clinically validated tool for assessing the impact your LBP/sciatica is having on you. I will receive your form and add it to your file. Then we’ll re-test you after you’ve been on the course for a while. It will give you and me a more objective measure of your progress.

As you read the list below, think of yourself today. Please tick all of the below sentences that APPLY TO YOU TODAY. If the sentence does not apply to you, then please DO NOT TICK IT. Where you read “back”, you may swap in “sciatica” if that applies. PLEASE CLICK THE SUBMIT BUTTON AT THE BOTTOM OF THE FORM WHEN YOU HAVE COMPLETED IT.


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