Data form

For each item below click on the line to show your current status from worst to best possible

Please answer all questions based only on the previous 24 hours
Feeling of general well-being Very Poor Excellent
Presence and severity of bodily pain Extreme No Problem
Feeling washed out or drained Extremely Fatigued Full of Energy
Sleep quality Very Poor Excellent
Difficulty breathing or shortness of breath Extreme No Problem
Appetite Very Poor Excellent
If you have a current fistula, how well do you think it is working today Not working Working Perfectly