Parkinson's Disease Questionnaire

If question applies to you or someone you know,
change answer from "No" to "Yes", and click on the
"Interpret Questionnaire" button.

1.	Has your handwriting become smaller?	Yes No
2.	Do you have trouble getting out of a chair?	Yes No
3.	Do people say they cannot hear you because your voice is softer?	Yes No
4.	Do you ever seem to be stuck to the floor?	Yes No
5.	Do people notice that you are not showing facial expressions?	Yes No
6.	Do your hands or legs shake?	Yes No
7.	Do you have difficulty dressing?	Yes No
8.	Do you shuffle your feet when you walk?	Yes No
9.	Do you take tiny steps when you walk?	Yes No
10.	Is your balance poor?	Yes No
11.	Has anyone ever asked you if you have Parkinson's Disease?	Yes No
12.	Have you ever taken L-dopa, levodopa, Sinemet?	Yes No