Activities affected by clutter or hoarding problem	Can do it easily	Can do it with a little difficulty	Can do it with moderate difficulty	Can do it with great difficulty	Unable to do	N/A
1. Prepare food	1	2	3	4	5	6
2. Use refrigerator	1	2	3	4	5	6
3. Use stove	1	2	3	4	5	6
4. Use kitchen sink	1	2	3	4	5	6
5. Eat at table	1	2	3	4	5	6
6. Move around inside the house	1	2	3	4	5	6
7. Exit home quickly	1	2	3	4	5	6
8. Use toilet	1	2	3	4	5	6
9. Use bath/shower	1	2	3	4	5	6
10. Use bathroom sink	1	2	3	4	5	6
11. Answer door quickly	1	2	3	4	5	6
12. Sit in sofa/chair	1	2	3	4	5	6
13. Sleep in bed	1	2	3	4	5	6
14. Do laundry	1	2	3	4	5	6
15. Find important things (such as bills, tax forms, etc.)	1	2	3	4	5	6