Please choose the most appropriate response to the following questions related to problems associated with the function of your facial muscles.

For each question, consider your function during the past month.

5 = No difficulty 

4 = A little difficulty

3 = Some difficulty 

2 = Much difficulty

1 = Usually did not eat because of health

0 = Usually did not eat because of other reasons

Please choose the most appropriate response to the following questions related to problems associated with the function of your facial muscles.

For each question, consider your function during the past month.

6 = All of the time 

5 = Most of the time 

4 = A good bit of the time

3 = Some of the time

2 = A little bit of the time

1 = None of the time

 

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