1. How old are you?
   18 to 28 years    29 to 44 years    45 to 60 years    61 years or older
2. Does your brother, sister, mother or father have arthritis? (directly related family members only, not step-families or in-laws)
   Yes    No
3. With respect to your weight, do you consider yourself to be:
   Thin    About normal weight    Somewhat overweight    Very overweight
4. Have you seriously injured one or more of your joints in the past?
   Yes    No
5. Do you do physical work requiring frequent, repetitive movements?
   Yes    No
6. Do you feel stiff in the morning or after sitting still for a long period during the day?
   Yes    No
7. Does your knee, shoulder, elbow, hip and/or other joints such as the joints in your fingers hurt or ache at times when you have not directly injured them?
   Yes    No
8. Do you have trouble sleeping because of pain associated with your joints?
   Yes    No

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