CDEs
Forms
In the past 30 days How difficult has it been for you to get an erection when you wanted to? (If you use pills, injections, or a penis pump to help you get an erection, please answer this question thinking about the times that you used these aids.)
In the past 7 days, I felt stressed.
In the past 7 days My child had trouble sleeping when he/she had pain.
In the past 7 days I could keep up when I played with other kids.
In the past 7 days, when I was in pain I talked about my pain.
CURRENT level of confidence I can take my medication when there is a change in my usual day (unexpected things happen).
CURRENT level of confidence I can remember to take my medication as prescribed.
In the past 30 days How would you rate your ability to have a satisfying orgasm/climax?
In the past 7 days It was hard to stay standing when I had pain.
In the past 7 days I had trouble finishing things because I was too tired
In the past 7 days I am able to perform my daily routines
In the past 7 days My child worried when he/she was at home.
In the past 7 days, My child's mouth was dry.
In the past 7 days Other kids wanted to be my child's friend.
In the past 7 days, I was in a good mood.
Are you able to go for a walk of at least 15 minutes?
In the past 7 days I felt like something awful might happen.
In the past 7 days My child had trouble finishing things because he/she was too tired.
In the past 7 days My child could pour a drink from a full pitcher.
In the past 7 days My child was so angry he/she felt like yelling at somebody.
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