Table 1. Centers for Disease Control and Prevention Healthy Days Instrument^a .

Number	Question
1	Would you say that in general your health is excellent, very good, good, fair, or poor?
2	Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good?
3	Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?
4	During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation?

^a Also called the HRQoL-4 survey and includes all 4 questions.