Available in English.

Categories of questions asked:

• Pain/fatigue
• Balance
• Recent Falls
• Confidence
• Activity

Examples of questions asked:

Do you experience pain or fatigue when walking? Reply YES or NO.

Have you had a fall in the past week? Reply YES or NO

Do you feel like your walking pattern has changed recently? Reply YES or NO.

Do you avoid certain activities because of fear of falling? Reply YES or NO.

Have stairs become harder to navigate lately? Reply YES or NO.