Reading small print, such as labels on medicine bottle, a telephone book, food labels, the newspaper, or a book? —Please choose an option—NoA littleA moderate amountA great dealUnable to do the activity
Reading a large-print book or large-print newspaper or numbers on a telephone? —Please choose an option—NoA littleA moderate amountA great dealUnable to do the activity
Recognizing people when they are close to you? —Please choose an option—NoA littleA moderate amountA great dealUnable to do the activity
Seeing steps, stairs, or curbs? —Please choose an option—NoA littleA moderate amountA great dealUnable to do the activity
Reading traffic signs, street signs, or store signs? —Please choose an option—NoA littleA moderate amountA great dealUnable to do the activity
Doing fine handwork like sewing, knitting, crocheting, or carpentry? —Please choose an option—NoA littleA moderate amountA great dealUnable to do the activity
Writing checks or filling out forms? —Please choose an option—NoA littleA moderate amountA great dealUnable to do the activity
Playing games such as bingo, dominos, card games, mahjong? —Please choose an option—NoA littleA moderate amountA great dealUnable to do the activity
Taking part in sports like bowling, tennis, handball or golf? —Please choose an option—NoA littleA moderate amountA great dealUnable to do the activity
Cooking? —Please choose an option—NoA littleA moderate amountA great dealUnable to do the activity
Watching television? —Please choose an option—NoA littleA moderate amountA great dealUnable to do the activity
Do you currently drive a car? —Please choose an option—YesNo
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