Your Health and Well-Being

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If you have any queries or concerns please contact the Burns Senior Physiotherapist

by Phone: 08 6152 2222

or

by Email: FSH.BurnsOutpatientClinic@health.wa.gov.au

This questionnaire asks for your views about your health. This information will help keep track of how you feel and how well you are able to do your usual activities. Thank you for completing the survey!

For each of the following questions, please select the one that best describes your answer.

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Last Updated: 25/08/2023