| SPECIFICATION |
{"test":[{"content":[{"choice":[{"choiceId":5330,"choiceText":"UNSCORED - Patient not interested in activity","ien":100293,"legacyValue":0,"sequence":1},{"choiceId":5331,"choiceText":"NOT difficult","ien":100294,"legacyValue":1,"sequence":2
on device, adaptive device, or an adaptive technique to assist with the\r\nactivity then please respond as though you were using the device or technique.","max":0,"min":0,"questionDisplay":81372,"questionId":8769,"questionText":"Read mail",
ugh you were using the device or technique.","max":0,"min":0,"questionDisplay":81372,"questionId":8787,"questionText":"Adjust to bright light","required":true,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":200}],"display":[{"ali
gnment":"L","columns":1,"component":"RA","fontBold":false,"fontColor":"clWindowText","fontItalic":false,"fontName":"MS Sans Serif","fontSize":8,"fontUnderlined":false,"id":81351,"left":8,"mask":"662|||"},{"alignment":"L","columns":0,"compon
ent":null,"fontBold":false,"fontColor":"clWindowText","fontItalic":false,"fontName":"MS Sans Serif","fontSize":8,"fontUnderlined":false,"id":81371,"left":3,"mask":
null},{"alignment":"L","columns":0,"component":null,"fontBold":false,"fontColor":"clWindowText","fontItalic":false,"fontName":"MS Sans Serif","fontSize":8,"fontUnderlined":false,"id":81372,"left":2,"mask":null}],"info":{"author":null,"auxDa
te":null,"auxVersion":null,"copyrightText":null,"copyrighted":false,"dllDate":null,"dllVersion":null,"enteredBy":"ELIZABETH GRIFFITH","entryDate":"2022-07-29","fullText":true,"id":295,"interpretiveText":null,"lastEditDate":3230815.1752,"las
tEditedBy":"ELIZABETH GRIFFITH","legacy":false,"licenseCurrent":false,"name":"LVVFQ","national":false,"normSample":null,"operational":"Y","printTitle":"Low Vision Visual Functioning Questionnaire","publicationDate":2016,"publisher":null,"pu
rpose":null,"reference":"STELMACK, J. and MASSOF, R. (2007). Using the VA LV VFQ-48 and LV VFQ-20 in Low Vision Rehabilitation. OPTOMETRY AND VISION SCIENCE, 84(8), 705-709.","requireSignature":false,"requiresLicense":"N","scoringRevision"
:1,"scoringRoutine":null,"scoringTag":null,"staffOnly":null,"submitNational":true,"suicideriskRoutine":null,"suicideriskTag":null,"targetPopulation":null,"version":null,"wasOperational":true},"report":{"id":218,"instrument":295,"template":"
|Low Vision Visual Functioning Questionnaire (LVVFQ)\r\n| \r\n| Date Given: <.Date_Given.>\r\n| Clinician: <.Staff_Ordered_By.>\r\n| Location: <.Location.>\r\n| \r\n| Veteran: <.Patient_Name_Last_First.>\r\n| SSN: <.Patient_SS
N.>\r\n| DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)\r\n| Gender: <.Patient_Gender.>\r\n| \r\n| LVVFQ Total Score = <-TOTAL->\r\n| \r\n| \r\n|Questions and Answers:\r\n| \r\n| 1. Read newspaper or magazine articles\r\n|
"required":true,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":20},{"choice":[{"choiceId":5330,"choiceText":"UNSCORED - Patient not interested in activity","ien":100293,"legacyValue":0,"sequence":1},{"choiceId":5331,"choiceText"
<*Answer_8768*>\r\n| 2. Read mail\r\n| <*Answer_8769*>\r\n| 3. Read menus\r\n| <*Answer_8776*>\r\n| 4. Read small print on package labels\r\n| <*Answer_8770*>\r\n| 5. Keep your place while reading\r\n|
<*Answer_8771*>\r\n| 6. See photos\r\n| <*Answer_8784*>\r\n| 7. Find something on a crowded shelf\r\n| <*Answer_8781*>\r\n| 8. Identify medicine\r\n| <*Answer_8778*>\r\n| 9. Tell time\r\n| <*Answer_8779
*>\r\n| 10. Read street signs\r\n| <*Answer_8786*>\r\n| 11. Read print on TV\r\n| <*Answer_8783*>\r\n| 12. Watch TV\r\n| <*Answer_8782*>\r\n| 13. Handle finances\r\n| <*Answer_8772*>\r\n| 14. Take a message
\r\n| <*Answer_8773*>\r\n| 15. Prepare meals\r\n| <*Answer_8775*>\r\n| 16. Use appliance dials\r\n| <*Answer_8780*>\r\n| 17. Groom yourself\r\n| <*Answer_8777*>\r\n| 18. Eat and drink neatly\r\n| <*Answ
er_8774*>\r\n| 19. Get around outdoors in places you know\r\n| <*Answer_8785*>\r\n| 20. Adjust to bright light\r\n| <*Answer_8787*>\r\n| \r\n|Information contained in this note is based on a self-report assessment \r\n|and
is not sufficient to use alone for diagnostic purposes. Assessment \r\n|results should be verified for accuracy and used in conjunction with \r\n|other diagnostic activities.\r\n"},"scaleGroup":[{"grid1":0,"grid2":0,"grid3":0,"id":346,"inst
rument":295,"name":"LVVFQ","ordInc":4,"ordMax":80,"ordMin":0,"ordTitle":"LVVFQ","scale":[{"groupId":346,"id":1455,"name":"TOTAL","scoringKey":[{"id":14327,"questionId":8768,"scaleId":1455,"targetText":"UNSCORED - Patient not interested in a
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aleId":1455,"targetText":"EXTREMELY difficult","value":3},{"id":14331,"questionId":8768,"scaleId":1455,"targetText":"IMPOSSIBLE","value":4},{"id":14332,"questionId":8769,"scaleId":1455,"targetText":"UNSCORED - Patient not interested in acti
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"SLIGHTLY\/MODERATELY difficult","value":2},{"id":14335,"questionId":8769,"scaleId":1455,"targetText":"EXTREMELY difficult","value":3},{"id":14336,"questionId":8769,"scaleId":1455,"targetText":"IMPOSSIBLE","value":4},{"id":14337,"questionId
":8770,"scaleId":1455,"targetText":"UNSCORED - Patient not interested in activity","value":0},{"id":14338,"questionId":8770,"scaleId":1455,"targetText":"NOT difficult","value":1},{"id":14339,"questionId":8770,"scaleId":1455,"targetText":"SL
IGHTLY\/MODERATELY difficult","value":2},{"id":14340,"questionId":8770,"scaleId":1455,"targetText":"EXTREMELY difficult","value":3},{"id":14341,"questionId":8770,"scaleId":1455,"targetText":"IMPOSSIBLE","value":4},{"id":14342,"questionId":8
771,"scaleId":1455,"targetText":"UNSCORED - Patient not interested in activity","value":0},{"id":14343,"questionId":8771,"scaleId":1455,"targetText":"NOT difficult","value":1},{"id":14344,"questionId":8771,"scaleId":1455,"targetText":"SLIGH
TLY\/MODERATELY difficult","value":2},{"id":14345,"questionId":8771,"scaleId":1455,"targetText":"EXTREMELY difficult","value":3},{"id":14346,"questionId":8771,"scaleId":1455,"targetText":"IMPOSSIBLE","value":4},{"id":14347,"questionId":8772
,"scaleId":1455,"targetText":"UNSCORED - Patient not interested in activity","value":0},{"id":14348,"questionId":8772,"scaleId":1455,"targetText":"NOT difficult","value":1},{"id":14349,"questionId":8772,"scaleId":1455,"targetText":"SLIGHTLY
\/MODERATELY difficult","value":2},{"id":14350,"questionId":8772,"scaleId":1455,"targetText":"EXTREMELY difficult","value":3},{"id":14351,"questionId":8772,"scaleId":1455,"targetText":"IMPOSSIBLE","value":4},{"id":14352,"questionId":8773,"s
caleId":1455,"targetText":"UNSCORED - Patient not interested in activity","value":0},{"id":14353,"questionId":8773,"scaleId":1455,"targetText":"NOT difficult","value":1},{"id":14354,"questionId":8773,"scaleId":1455,"targetText":"SLIGHTLY\/M
ODERATELY difficult","value":2},{"id":14355,"questionId":8773,"scaleId":1455,"targetText":"EXTREMELY difficult","value":3},{"id":14356,"questionId":8773,"scaleId":1455,"targetText":"IMPOSSIBLE","value":4},{"id":14357,"questionId":8774,"scal
eId":1455,"targetText":"UNSCORED - Patient not interested in activity","value":0},{"id":14358,"questionId":8774,"scaleId":1455,"targetText":"NOT difficult","value":1},{"id":14359,"questionId":8774,"scaleId":1455,"targetText":"SLIGHTLY\/MODE
lue":3,"sequence":4},{"choiceId":5334,"choiceText":"IMPOSSIBLE","ien":100297,"legacyValue":4,"sequence":5}],"choiceDisplay":81351,"choiceIdentifier":0,"choiceIdentifierIen":42304,"choiceTypeId":15059,"designator":"3.","hint":null,"id":8841,
RATELY difficult","value":2},{"id":14360,"questionId":8774,"scaleId":1455,"targetText":"EXTREMELY difficult","value":3},{"id":14361,"questionId":8774,"scaleId":1455,"targetText":"IMPOSSIBLE","value":4},{"id":14362,"questionId":8775,"scaleId
":1455,"targetText":"UNSCORED - Patient not interested in activity","value":0},{"id":14363,"questionId":8775,"scaleId":1455,"targetText":"NOT difficult","value":1},{"id":14364,"questionId":8775,"scaleId":1455,"targetText":"SLIGHTLY\/MODERAT
ELY difficult","value":2},{"id":14365,"questionId":8775,"scaleId":1455,"targetText":"EXTREMELY difficult","value":3},{"id":14366,"questionId":8775,"scaleId":1455,"targetText":"IMPOSSIBLE","value":4},{"id":14367,"questionId":8776,"scaleId":1
455,"targetText":"UNSCORED - Patient not interested in activity","value":0},{"id":14368,"questionId":8776,"scaleId":1455,"targetText":"NOT difficult","value":1},{"id":14369,"questionId":8776,"scaleId":1455,"targetText":"SLIGHTLY\/MODERATELY
difficult","value":2},{"id":14370,"questionId":8776,"scaleId":1455,"targetText":"EXTREMELY difficult","value":3},{"id":14371,"questionId":8776,"scaleId":1455,"targetText":"IMPOSSIBLE","value":4},{"id":14372,"questionId":8777,"scaleId":1455
,"targetText":"UNSCORED - Patient not interested in activity","value":0},{"id":14373,"questionId":8777,"scaleId":1455,"targetText":"NOT difficult","value":1},{"id":14374,"questionId":8777,"scaleId":1455,"targetText":"SLIGHTLY\/MODERATELY di
fficult","value":2},{"id":14375,"questionId":8777,"scaleId":1455,"targetText":"EXTREMELY difficult","value":3},{"id":14376,"questionId":8777,"scaleId":1455,
"targetText":"IMPOSSIBLE","value":4},{"id":14377,"questionId":8778,"scaleId":1455,"targetText":"UNSCORED - Patient not interested in activity","value":0},{"id":14378,"questionId":8778,"scaleId":1455,"targetText":"NOT difficult","value":1},{
"id":14379,"questionId":8778,"scaleId":1455,"targetText":"SLIGHTLY\/MODERATELY difficult","value":2},{"id":14380,"questionId":8778,"scaleId":1455,"targetText":"EXTREMELY difficult","value":3},{"id":14381,"questionId":8778,"scaleId":1455,"ta
rgetText":"IMPOSSIBLE","value":4},{"id":14382,"questionId":8779,"scaleId":1455,"targetText":"UNSCORED - Patient not interested in activity","value":0},{"id":14383,"questionId":8779,"scaleId":1455,"targetText":"NOT difficult","value":1},{"id
"instrument":295,"introDisplay":81371,"introId":2472,"introText":"For each of the following items select one response to indicate the difficulty level.\r\n||\r\nThese questions relate to reading and near vision activities. Remember if you u
":14384,"questionId":8779,"scaleId":1455,"targetText":"SLIGHTLY\/MODERATELY difficult","value":2},{"id":14385,"questionId":8779,"scaleId":1455,"targetText":"EXTREMELY difficult","value":3},{"id":14386,"questionId":8779,"scaleId":1455,"targe
tText":"IMPOSSIBLE","value":4},{"id":14387,"questionId":8780,"scaleId":1455,"targetText":"UNSCORED - Patient not interested in activity","value":0},{"id":14388,"questionId":8780,"scaleId":1455,"targetText":"NOT difficult","value":1},{"id":1
4389,"questionId":8780,"scaleId":1455,"targetText":"SLIGHTLY\/MODERATELY difficult","value":2},{"id":14390,"questionId":8780,"scaleId":1455,"targetText":"EXTREMELY difficult","value":3},{"id":14391,"questionId":8780,"scaleId":1455,"targetTe
xt":"IMPOSSIBLE","value":4},{"id":14392,"questionId":8781,"scaleId":1455,"targetText":"UNSCORED - Patient not interested in activity","value":0},{"id":14393,"questionId":8781,"scaleId":1455,"targetText":"NOT difficult","value":1},{"id":1439
4,"questionId":8781,"scaleId":1455,"targetText":"SLIGHTLY\/MODERATELY difficult","value":2},{"id":14395,"questionId":8781,"scaleId":1455,"targetText":"EXTREMELY difficult","value":3},{"id":14396,"questionId":8781,"scaleId":1455,"targetText"
:"IMPOSSIBLE","value":4},{"id":14397,"questionId":8782,"scaleId":1455,"targetText":"UNSCORED - Patient not interested in activity","value":0},{"id":14398,"questionId":8782,"scaleId":1455,"targetText":"NOT difficult","value":1},{"id":14399,"
questionId":8782,"scaleId":1455,"targetText":"SLIGHTLY\/MODERATELY difficult","value":2},{"id":14400,"questionId":8782,"scaleId":1455,"targetText":"EXTREMELY difficult","value":3},{"id":14401,"questionId":8782,"scaleId":1455,"targetText":"I
MPOSSIBLE","value":4},{"id":14402,"questionId":8783,"scaleId":1455,"targetText":"UNSCORED - Patient not interested in activity","value":0},{"id":14403,"questionId":8783,"scaleId":1455,"targetText":"NOT difficult","value":1},{"id":14404,"que
stionId":8783,"scaleId":1455,"targetText":"SLIGHTLY\/MODERATELY difficult","value":2},{"id":14405,"questionId":8783,"scaleId":1455,"targetText":"EXTREMELY difficult","value":3},{"id":14406,"questionId":8783,"scaleId":1455,"targetText":"IMPO
SSIBLE","value":4},{"id":14407,"questionId":8784,"scaleId":1455,"targetText":"UNSCORED - Patient not interested in activity","value":0},{"id":14408,"questionId":8784,"scaleId":1455,"targetText":"NOT difficult","value":1},{"id":14409,"questi
se\r\na low vision device, adaptive device, or an adaptive technique to assist with the\r\nactivity then please respond as though you were using the device or technique.","max":0,"min":0,"questionDisplay":81372,"questionId":8776,"questionTe
onId":8784,"scaleId":1455,"targetText":"SLIGHTLY\/MODERATELY difficult","value":2},{"id":14410,"questionId":8784,"scaleId":1455,"targetText":"EXTREMELY difficult","value":3},{"id":14411,"questionId":8784,"scaleId":1455,"targetText":"IMPOSSI
BLE","value":4},{"id":14412,"questionId":8785,"scaleId":1455,"targetText":"UNSCORED - Patient not interested in activity","value":0},{"id":14413,"questionId":8785,"scaleId":1455,"targetText":"NOT difficult","value":1},{"id":14414,"questionI
d":8785,"scaleId":1455,"targetText":"SLIGHTLY\/MODERATELY difficult","value":2},{"id":14415,"questionId":8785,"scaleId":1455,"targetText":"EXTREMELY difficult","value":3},{"id":14416,"questionId":8785,"scaleId":1455,"targetText":"IMPOSSIBLE
","value":4},{"id":14417,"questionId":8786,"scaleId":1455,"targetText":"UNSCORED - Patient not interested in activity","value":0},{"id":14418,"questionId":8786,
"scaleId":1455,"targetText":"NOT difficult","value":1},{"id":14419,"questionId":8786,"scaleId":1455,"targetText":"SLIGHTLY\/MODERATELY difficult","value":2},{"id":14420,"questionId":8786,"scaleId":1455,"targetText":"EXTREMELY difficult","va
lue":3},{"id":14421,"questionId":8786,"scaleId":1455,"targetText":"IMPOSSIBLE","value":4},{"id":14422,"questionId":8787,"scaleId":1455,"targetText":"UNSCORED - Patient not interested in activity","value":0},{"id":14423,"questionId":8787,"sc
aleId":1455,"targetText":"NOT difficult","value":1},{"id":14424,"questionId":8787,"scaleId":1455,"targetText":"SLIGHTLY\/MODERATELY difficult","value":2},{"id":14425,"questionId":8787,"scaleId":1455,"targetText":"EXTREMELY difficult","value
":3},{"id":14426,"questionId":8787,"scaleId":1455,"targetText":"IMPOSSIBLE","value":4}],"sequence":10,"xLabel":"TOTAL"}],"sequence":10}],"spec":{"entryChecksum":1429358636,"entrySpec":"{\"name\": \"LVVFQ\",\r\n \"restartDays\": 2,\r\n \"pri
ntTitle\": \"Low Vision Visual Functioning Questionnaire\",\r\n \"content\":[\r\n {\"id\": \"i2472\", \"type\": \"IntroText\",\r\n \"text\": \"<strong>For each of the following <u>items<\/u> select one response to indicate the difficul
ty\r\n level.<\/strong><br\/><br\/>These questions relate to reading and near vision\r\n activities. Remember if you use a low vision device, adaptive device, or an\r\n adaptive technique to assist with the activity then please respond as t
xt":"Read menus","required":true,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":30},{"choice":[{"choiceId":5330,"choiceText":"UNSCORED - Patient not interested in activity","ien":100293,"legacyValue":0,"sequence":1},{"choiceId":
hough you\r\n were using the device or technique.\"\r\n },\r\n {\"id\": \"q8768\", \"type\": \"ChoiceQuestion\", \"required\": true, \"inline\": false,\r\n \"text\": \"1. Read newspaper or magazine articles\",\r\n \"intro\": \"<s
trong>For each of the following <u>items<\/u> select one response to indicate the difficulty\r\n level.<\/strong><br\/><br\/>These questions relate to reading and near vision\r\n activities. Remember if you use a low vision device, adaptive
device, or an\r\n adaptive technique to assist with the activity then please respond as though you\r\n were using the device or technique.\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5331\", \"text\": \"1. NOT diffic
ult\", \"quickKey\": 1},\r\n {\"id\": \"c5332\", \"text\": \"2. SLIGHTLY\/MODERATELY difficult\", \"quickKey\": 2},\r\n {\"id\": \"c5333\", \"text\": \"3. EXTREMELY difficult\", \"quickKey\": 3},\r\n {\"id\": \"c5334\", \"text\"
: \"4. IMPOSSIBLE\", \"quickKey\": 4},\r\n {\"id\": \"c5330\", \"text\": \"9. UNSCORED - Patient not interested in activity\", \"quickKey\": 9}\r\n ]},\r\n {\"id\": \"q8769\", \"type\": \"ChoiceQuestion\", \"required\": true, \"
inline\": false,\r\n \"text\": \"2. Read mail\",\r\n \"intro\": \"<strong>For each of the following <u>items<\/u> select one response to indicate the difficulty\r\n level.<\/strong><br\/><br\/>These questions relate to reading and nea
r vision\r\n activities. Remember if you use a low vision device, adaptive device, or an\r\n adaptive technique to assist with the activity then please respond as though you\r\n were using the device or technique.\",\r\n \"columns\": 1,\
r\n \"choices\":[\r\n {\"id\": \"c5331\", \"text\": \"1. NOT difficult\", \"quickKey\": 1},\r\n {\"id\": \"c5332\", \"text\": \"2. SLIGHTLY\/MODERATELY difficult\", \"quickKey\": 2},\r\n {\"id\": \"c5333\", \"text\": \"3. EXT
REMELY difficult\", \"quickKey\": 3},\r\n {\"id\": \"c5334\", \"text\": \"4. IMPOSSIBLE\", \"quickKey\": 4},\r\n {\"id\": \"c5330\", \"text\": \"9. UNSCORED - Patient not interested in activity\", \"quickKey\": 9}\r\n ]},\r\n
{\"id\": \"q8776\", \"type\": \"ChoiceQuestion\", \"required\": true, \"inline\": false,\r\n \"text\": \"3. Read menus\",\r\n \"intro\": \"<strong>For each of the following <u>items<\/u> select one response to indicate the difficult
5331,"choiceText":"NOT difficult","ien":100294,"legacyValue":1,"sequence":2},{"choiceId":5332,"choiceText":"SLIGHTLY\/MODERATELY difficult","ien":100295,
y\r\n level.<\/strong><br\/><br\/>These questions relate to reading and near vision
\r\n activities. Remember if you use a low vision device, adaptive device, or an\r\n adaptive technique to assist with the activity then please respond as though you\r\n were using the device or technique.\",\r\n \"columns\": 1,\r\n \
"choices\":[\r\n {\"id\": \"c5331\", \"text\": \"1. NOT difficult\", \"quickKey\": 1},\r\n {\"id\": \"c5332\", \"text\": \"2. SLIGHTLY\/MODERATELY difficult\", \"quickKey\": 2},\r\n {\"id\": \"c5333\", \"text\": \"3. EXTREMELY d
ifficult\", \"quickKey\": 3},\r\n {\"id\": \"c5334\", \"text\": \"4. IMPOSSIBLE\", \"quickKey\": 4},\r\n {\"id\": \"c5330\", \"text\": \"9. UNSCORED - Patient not interested in activity\", \"quickKey\": 9}\r\n ]},\r\n {\"id\
": \"q8770\", \"type\": \"ChoiceQuestion\", \"required\": true, \"inline\": false,\r\n \"text\": \"4. Read small print on package labels\",\r\n \"intro\": \"<strong>For each of the following <u>items<\/u> select one response to indica
te the difficulty\r\n level.<\/strong><br\/><br\/>These questions relate to reading and near vision\r\n activities. Remember if you use a low vision device, adaptive device, or an\r\n adaptive technique to assist with the activity then plea
se respond as though you\r\n were using the device or technique.\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5331\", \"text\": \"1. NOT difficult\", \"quickKey\": 1},\r\n {\"id\": \"c5332\", \"text\": \"2. SLIGHTL
Y\/MODERATELY difficult\", \"quickKey\": 2},\r\n {\"id\": \"c5333\", \"text\": \"3. EXTREMELY difficult\", \"quickKey\": 3},\r\n {\"id\": \"c5334\", \"text\": \"4. IMPOSSIBLE\", \"quickKey\": 4},\r\n {\"id\": \"c5330\", \"te
xt\": \"9. UNSCORED - Patient not interested in activity\", \"quickKey\": 9}\r\n ]},\r\n {\"id\": \"q8771\", \"type\": \"ChoiceQuestion\", \"required\": true, \"inline\": false,\r\n \"text\": \"5. Keep your place while reading\",\r\n
\"intro\": \"<strong>For each of the following <u>items<\/u> select one response to indicate the difficulty\r\n level.<\/strong><br\/><br\/>These questions relate to reading and near vision\r\n activities. Remember if you use a low visi
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on device, adaptive device, or an\r\n adaptive technique to assist with the activity then please respond as though you\r\n were using the device or technique.\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5331\", \"text
\": \"1. NOT difficult\", \"quickKey\": 1},\r\n {\"id\": \"c5332\", \"text\": \"2. SLIGHTLY\/MODERATELY difficult\", \"quickKey\": 2},\r\n {\"id\": \"c5333\", \"text\": \"3. EXTREMELY difficult\", \"quickKey\": 3},\r\n {\"id\":
\"c5334\", \"text\": \"4. IMPOSSIBLE\", \"quickKey\": 4},\r\n {\"id\": \"c5330\", \"text\": \"9. UNSCORED - Patient not interested in activity\", \"quickKey\": 9}\r\n ]},\r\n {\"id\": \"q8784\", \"type\": \"ChoiceQuestion\", \"r
equired\": true, \"inline\": false,\r\n \"text\": \"6. See photos\",\r\n \"intro\": \"<strong>For each of the following <u>items<\/u> select one response to indicate the difficulty\r\n level.<\/strong><br\/><br\/>These questions relat
e to reading and near vision\r\n activities. Remember if you use a low vision device, adaptive device, or an\r\n adaptive technique to assist with the activity then please respond as though you\r\n were using the device or technique.\",\r\n
\"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5331\", \"text\": \"1. NOT difficult\", \"quickKey\": 1},\r\n {\"id\": \"c5332\", \"text\": \"2. SLIGHTLY\/MODERATELY difficult\", \"quickKey\": 2},\r\n {\"id\": \"c5333\"
, \"text\": \"3. EXTREMELY difficult\", \"quickKey\": 3},\r\n {\"id\": \"c5334\", \"text\": \"4. IMPOSSIBLE\", \"quickKey\": 4},\r\n {\"id\": \"c5330\", \"text\": \"9. UNSCORED - Patient not interested in activity\", \"quickKey\
": 9}\r\n ]},\r\n {\"id\": \"q8781\", \"type\": \"ChoiceQuestion\", \"required\": true, \"inline\": false,
\r\n \"text\": \"7. Find something on a crowded shelf\",\r\n \"intro\": \"<strong>For each of the following <u>items<\/u> select one response to indicate the difficulty\r\n level.<\/strong><br\/><br\/>These questions relate to reading
and near vision\r\n activities. Remember if you use a low vision device, adaptive device, or an\r\n adaptive technique to assist with the activity then please respond as though you\r\n were using the device or technique.\",\r\n \"column
eIdentifier":0,"choiceIdentifierIen":42304,"choiceTypeId":15059,"designator":"4.","hint":null,"id":8835,"instrument":295,"introDisplay":81371,"introId":2472,"introText":"For each of the following items select one response to indicate the di
s\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5331\", \"text\": \"1. NOT difficult\", \"quickKey\": 1},\r\n {\"id\": \"c5332\", \"text\": \"2. SLIGHTLY\/MODERATELY difficult\", \"quickKey\": 2},\r\n {\"id\": \"c5333\", \"text\":
\"3. EXTREMELY difficult\", \"quickKey\": 3},\r\n {\"id\": \"c5334\", \"text\": \"4. IMPOSSIBLE\", \"quickKey\": 4},\r\n {\"id\": \"c5330\", \"text\": \"9. UNSCORED - Patient not interested in activity\", \"quickKey\": 9}\r\n
]},\r\n {\"id\": \"q8778\", \"type\": \"ChoiceQuestion\", \"required\": true, \"inline\": false,\r\n \"text\": \"8. Identify medicine\",\r\n \"intro\": \"<strong>For each of the following <u>items<\/u> select one response to indicat
e the difficulty\r\n level.<\/strong><br\/><br\/>These questions relate to reading and near vision\r\n activities. Remember if you use a low vision device, adaptive device, or an\r\n adaptive technique to assist with the activity then pleas
e respond as though you\r\n were using the device or technique.\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5331\", \"text\": \"1. NOT difficult\", \"quickKey\": 1},\r\n {\"id\": \"c5332\", \"text\": \"2. SLIGHTLY
\/MODERATELY difficult\", \"quickKey\": 2},\r\n {\"id\": \"c5333\", \"text\": \"3. EXTREMELY difficult\", \"quickKey\": 3},\r\n {\"id\": \"c5334\", \"text\": \"4. IMPOSSIBLE\", \"quickKey\": 4},\r\n {\"id\": \"c5330\", \"tex
t\": \"9. UNSCORED - Patient not interested in activity\", \"quickKey\": 9}\r\n ]},\r\n {\"id\": \"q8779\", \"type\": \"ChoiceQuestion\", \"required\": true, \"inline\": false,\r\n \"text\": \"9. Tell time\",\r\n \"intro\": \"<str
ong>For each of the following <u>items<\/u> select one response to indicate the difficulty\r\n level.<\/strong><br\/><br\/>These questions relate to reading and near vision\r\n activities. Remember if you use a low vision device, adaptive d
evice, or an\r\n adaptive technique to assist with the activity then please respond as though you\r\n were using the device or technique.\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5331\", \"text\": \"1. NOT difficul
t\", \"quickKey\": 1},\r\n {\"id\": \"c5332\", \"text\": \"2. SLIGHTLY\/MODERATELY difficult\", \"quickKey\": 2},\r\n {\"id\": \"c5333\", \"text\": \"3. EXTREMELY difficult\", \"quickKey\": 3},\r\n {\"id\": \"c5334\", \"text\":
},{"choiceId":5332,"choiceText":"SLIGHTLY\/MODERATELY difficult","ien":100295,"legacyValue":2,"sequence":3},{"choiceId":5333,"choiceText":"EXTREMELY difficult","ien":100296,"legacyValue":3,"sequence":4},{"choiceId":5334,"choiceText":"IMPOSS
fficulty level.\r\n||\r\nThese questions relate to reading and near vision activities. Remember if you use\r\na low vision device, adaptive device, or an adaptive technique to assist with the\r\nactivity then please respond as though you we
\"4. IMPOSSIBLE\", \"quickKey\": 4},\r\n {\"id\": \"c5330\", \"text\": \"9. UNSCORED - Patient not interested in activity\", \"quickKey\": 9}\r\n ]},\r\n {\"id\": \"i2530\", \"type\": \"IntroText\",\r\n \"text\": \"These ques
tions relate to distance visual activities. Remember if you use a low\r\n vision device, adaptive device, or an adaptive technique to assist with the\r\n activity then please respond as though you were using the device or technique.\"\r\n
},\r\n {\"id\": \"q8786\", \"type\": \"ChoiceQuestion\", \"required\": true, \"inline\": false,\r\n \"text\": \"10. Read street signs\",\r\n \"intro\": \"These questions relate to distance visual activities. Remember if you use a
low\r\n vision device, adaptive device, or an adaptive technique to assist with the\r\n activity then please respond as though you were using the device or technique.\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5331\"
, \"text\": \"1. NOT difficult\", \"quickKey\": 1},\r\n {\"id\": \"c5332\", \"text\": \"2. SLIGHTLY\/MODERATELY difficult\", \"quickKey\": 2},
\r\n {\"id\": \"c5333\", \"text\": \"3. EXTREMELY difficult\", \"quickKey\": 3},\r\n {\"id\": \"c5334\", \"text\": \"4. IMPOSSIBLE\", \"quickKey\": 4},\r\n {\"id\": \"c5330\", \"text\": \"9. UNSCORED - Patient not interested
in activity\", \"quickKey\": 9}\r\n ]},\r\n {\"id\": \"q8783\", \"type\": \"ChoiceQuestion\", \"required\": true, \"inline\": false,\r\n \"text\": \"11. Read print on TV\",\r\n \"intro\": \"These questions relate to distance visu
al activities. Remember if you use a low\r\n vision device, adaptive device, or an adaptive technique to assist with the\r\n activity then please respond as though you were using the device or technique.\",\r\n \"columns\": 1,\r\n \"c
hoices\":[\r\n {\"id\": \"c5331\", \"text\": \"1. NOT difficult\", \"quickKey\": 1},\r\n {\"id\": \"c5332\", \"text\": \"2. SLIGHTLY\/MODERATELY difficult\", \"quickKey\": 2},\r\n {\"id\": \"c5333\", \"text\": \"3. EXTREMELY dif
ficult\", \"quickKey\": 3},\r\n {\"id\": \"c5334\", \"text\": \"4. IMPOSSIBLE\", \"quickKey\": 4},\r\n {\"id\": \"c5330\", \"text\": \"9. UNSCORED - Patient not interested in activity\", \"quickKey\": 9}\r\n ]},\r\n {\"id\":
re using the device or technique.","max":0,"min":0,"questionDisplay":81372,"questionId":8770,"questionText":"Read small print on package labels","required":true,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":40},{"choice":[{"cho
\"q8782\", \"type\": \"ChoiceQuestion\", \"required\": true, \"inline\": false,\r\n \"text\": \"12. Watch TV\",\r\n \"intro\": \"These questions relate to distance visual activities. Remember if you use a low\r\n vision device, adapt
ive device, or an adaptive technique to assist with the\r\n activity then please respond as though you were using the device or technique.\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5331\", \"text\": \"1. NOT difficu
lt\", \"quickKey\": 1},\r\n {\"id\": \"c5332\", \"text\": \"2. SLIGHTLY\/MODERATELY difficult\", \"quickKey\": 2},\r\n {\"id\": \"c5333\", \"text\": \"3. EXTREMELY difficult\", \"quickKey\": 3},\r\n {\"id\": \"c5334\", \"text\":
\"4. IMPOSSIBLE\", \"quickKey\": 4},\r\n {\"id\": \"c5330\", \"text\": \"9. UNSCORED - Patient not interested in activity\", \"quickKey\": 9}\r\n ]},\r\n {\"id\": \"i2531\", \"type\": \"IntroText\",\r\n \"text\": \"The follo
wing questions are about other daily living activities. Remember if you\r\n use a low vision device, adaptive device, or an adaptive technique to assist\r\n with the activity then please respond as though you were using the device or\r\n te
chnique.\"\r\n },\r\n {\"id\": \"q8772\", \"type\": \"ChoiceQuestion\", \"required\": true, \"inline\": false,\r\n \"text\": \"13. Handle finances\",\r\n \"intro\": \"The following questions are about other daily living activitie
s. Remember if you\r\n use a low vision device, adaptive device, or an adaptive technique to assist\r\n with the activity then please respond as though you were using the device or\r\n technique.\",\r\n \"columns\": 1,\r\n \"choices\"
:[\r\n {\"id\": \"c5331\", \"text\": \"1. NOT difficult\", \"quickKey\": 1},\r\n {\"id\": \"c5332\", \"text\": \"2. SLIGHTLY\/MODERATELY difficult\", \"quickKey\": 2},\r\n {\"id\": \"c5333\", \"text\": \"3. EXTREMELY difficult\"
, \"quickKey\": 3},\r\n {\"id\": \"c5334\", \"text\": \"4. IMPOSSIBLE\", \"quickKey\": 4},\r\n {\"id\": \"c5330\", \"text\": \"9. UNSCORED - Patient not interested in activity\", \"quickKey\": 9}\r\n ]},\r\n {\"id\": \"q8773
\", \"type\": \"ChoiceQuestion\", \"required\": true, \"inline\": false,\r\n \"text\": \"14. Take a message\",\r\n \"intro\": \"The following questions are about other daily living activities. Remember if you\r\n use a low vision devi
iceId":5330,"choiceText":"UNSCORED - Patient not interested in activity","ien":100293,"legacyValue":0,"sequence":1},{"choiceId":5331,"choiceText":"NOT difficult","ien":100294,"legacyValue":1,"sequence":2},{"choiceId":5332,"choiceText":"SLIG
ce, adaptive device, or an adaptive technique to assist\r\n with the activity then please respond as though you were using the device or\r\n technique.\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5331\", \"text\": \"1
. NOT difficult\", \"quickKey\": 1},\r\n {\"id\": \"c5332\", \"text\": \"2. SLIGHTLY\/MODERATELY difficult\", \"quickKey\": 2},
\r\n {\"id\": \"c5333\", \"text\": \"3. EXTREMELY difficult\", \"quickKey\": 3},\r\n {\"id\": \"c5334\", \"text\": \"4. IMPOSSIBLE\", \"quickKey\": 4},\r\n {\"id\": \"c5330\", \"text\": \"9. UNSCORED - Patient not interested
in activity\", \"quickKey\": 9}\r\n ]},\r\n {\"id\": \"q8775\", \"type\": \"ChoiceQuestion\", \"required\": true, \"inline\": false,\r\n \"text\": \"15. Prepare meals\",\r\n \"intro\": \"The following questions are about other da
ily living activities. Remember if you\r\n use a low vision device, adaptive device, or an adaptive technique to assist\r\n with the activity then please respond as though you were using the device or\r\n technique.\",\r\n \"columns\": 1
,\r\n \"choices\":[\r\n {\"id\": \"c5331\", \"text\": \"1. NOT difficult\", \"quickKey\": 1},\r\n {\"id\": \"c5332\", \"text\": \"2. SLIGHTLY\/MODERATELY difficult\", \"quickKey\": 2},\r\n {\"id\": \"c5333\", \"text\": \"3. E
XTREMELY difficult\", \"quickKey\": 3},\r\n {\"id\": \"c5334\", \"text\": \"4. IMPOSSIBLE\", \"quickKey\": 4},\r\n {\"id\": \"c5330\", \"text\": \"9. UNSCORED - Patient not interested in activity\", \"quickKey\": 9}\r\n ]},\r\
n {\"id\": \"q8780\", \"type\": \"ChoiceQuestion\", \"required\": true, \"inline\": false,\r\n \"text\": \"16. Use appliance dials\",\r\n \"intro\": \"The following questions are about other daily living activities. Remember if you\
r\n use a low vision device, adaptive device, or an adaptive technique to assist\r\n with the activity then please respond as though you were using the device or\r\n technique.\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\":
\"c5331\", \"text\": \"1. NOT difficult\", \"quickKey\": 1},\r\n {\"id\": \"c5332\", \"text\": \"2. SLIGHTLY\/MODERATELY difficult\", \"quickKey\": 2},\r\n {\"id\": \"c5333\", \"text\": \"3. EXTREMELY difficult\", \"quickKey\": 3},
HTLY\/MODERATELY difficult","ien":100295,"legacyValue":2,"sequence":3},{"choiceId":5333,"choiceText":"EXTREMELY difficult","ien":100296,"legacyValue":3,"sequence":4},{"choiceId":5334,"choiceText":"IMPOSSIBLE","ien":100297,"legacyValue":4,"s
\r\n {\"id\": \"c5334\", \"text\": \"4. IMPOSSIBLE\", \"quickKey\": 4},\r\n {\"id\": \"c5330\", \"text\": \"9. UNSCORED - Patient not interested in activity\", \"quickKey\": 9}\r\n ]},\r\n {\"id\": \"q8777\", \"type\": \"Cho
iceQuestion\", \"required\": true, \"inline\": false,\r\n \"text\": \"17. Groom yourself\",\r\n \"intro\": \"The following questions are about other daily living activities. Remember if you\r\n use a low vision device, adaptive device
, or an adaptive technique to assist\r\n with the activity then please respond as though you were using the device or\r\n technique.\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5331\", \"text\": \"1. NOT difficult\",
\"quickKey\": 1},\r\n {\"id\": \"c5332\", \"text\": \"2. SLIGHTLY\/MODERATELY difficult\", \"quickKey\": 2},\r\n {\"id\": \"c5333\", \"text\": \"3. EXTREMELY difficult\", \"quickKey\": 3},\r\n {\"id\": \"c5334\", \"text\": \"4.
IMPOSSIBLE\", \"quickKey\": 4},\r\n {\"id\": \"c5330\", \"text\": \"9. UNSCORED - Patient not interested in activity\", \"quickKey\": 9}\r\n ]},\r\n {\"id\": \"q8774\", \"type\": \"ChoiceQuestion\", \"required\": true, \"inline\
": false,\r\n \"text\": \"18. Eat and drink neatly\",\r\n \"intro\": \"The following questions are about other daily living activities. Remember if you\r\n use a low vision device, adaptive device, or an adaptive technique to assist\r
\n with the activity then please respond as though you were using the device or\r\n technique.\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5331\", \"text\": \"1. NOT difficult\", \"quickKey\": 1},\r\n {\"id\": \"c
5332\", \"text\": \"2. SLIGHTLY\/MODERATELY difficult\", \"quickKey\": 2},\r\n {\"id\": \"c5333\", \"text\": \"3. EXTREMELY difficult\", \"quickKey\": 3},\r\n {\"id\": \"c5334\", \"text\": \"4. IMPOSSIBLE\", \"quickKey\": 4},\r\n
{\"id\": \"c5330\", \"text\": \"9. UNSCORED - Patient not interested in activity\", \"quickKey\": 9}\r\n ]},
\r\n {\"id\": \"i2532\", \"type\": \"IntroText\",\r\n \"text\": \"The last set of questions deal with issues of mobility. Remember if you use a low\r\n vision device, adaptive device, or an adaptive technique to assist with the\r\n act
equence":5}],"choiceDisplay":81351,"choiceIdentifier":0,"choiceIdentifierIen":42304,"choiceTypeId":15059,"designator":"5.","hint":null,"id":8836,"instrument":295,"introDisplay":81371,"introId":2472,"introText":"For each of the following ite
ivity then please respond as though you were using the device or technique.\"\r\n },\r\n {\"id\": \"q8785\", \"type\": \"ChoiceQuestion\", \"required\": true, \"inline\": false,\r\n \"text\": \"19. Get around outdoors in places you
know\",\r\n \"intro\": \"The last set of questions deal with issues of mobility. Remember if you use a low\r\n vision device, adaptive device, or an adaptive technique to assist with the\r\n activity then please respond as though you wer
e using the device or technique.\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5331\", \"text\": \"1. NOT difficult\", \"quickKey\": 1},\r\n {\"id\": \"c5332\", \"text\": \"2. SLIGHTLY\/MODERATELY difficult\", \"qui
ckKey\": 2},\r\n {\"id\": \"c5333\", \"text\": \"3. EXTREMELY difficult\", \"quickKey\": 3},\r\n {\"id\": \"c5334\", \"text\": \"4. IMPOSSIBLE\", \"quickKey\": 4},\r\n {\"id\": \"c5330\", \"text\": \"9. UNSCORED - Patient no
t interested in activity\", \"quickKey\": 9}\r\n ]},\r\n {\"id\": \"q8787\", \"type\": \"ChoiceQuestion\", \"required\": true, \"inline\": false,\r\n \"text\": \"20. Adjust to bright light\",\r\n \"intro\": \"The last set of quest
ions deal with issues of mobility. Remember if you use a low\r\n vision device, adaptive device, or an adaptive technique to assist with the\r\n activity then please respond as though you were using the device or technique.\",\r\n \"colu
mns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5331\", \"text\": \"1. NOT difficult\", \"quickKey\": 1},\r\n {\"id\": \"c5332\", \"text\": \"2. SLIGHTLY\/MODERATELY difficult\", \"quickKey\": 2},\r\n {\"id\": \"c5333\", \"text\"
: \"3. EXTREMELY difficult\", \"quickKey\": 3},\r\n {\"id\": \"c5334\", \"text\": \"4. IMPOSSIBLE\", \"quickKey\": 4},\r\n {\"id\": \"c5330\", \"text\": \"9. UNSCORED - Patient not interested in activity\", \"quickKey\": 9}\r\n
]}]\r\n}","instrument":295,"lastUpdate":"2023-08-07T23:32:24","specIen":172},"verify":["601.71:295","601.72:8768","601.72:8769","601.72:8770","601.72:8771","601.72:8772","601.72:8773","601.72:8774","601.72:8775","601.72:8776","601.72:8777
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ms select one response to indicate the difficulty level.\r\n||\r\nThese questions relate to reading and near vision activities. Remember if you use\r\na low vision device, adaptive device, or an adaptive technique to assist with the\r\nacti
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601.76:8842","601.76:8843","601.76:8844","601.76:8845","601.76:8846","601.76:8847","601.76:8848","601.76:8849","601.76:8850","601.76:8851","601.76:8852","601.86:346","601.87:1455","601.88:81351","601.88:81371","601.88:81372","601.89:42304",
"601.91:14327","601.91:14328","601.91:14329","601.91:14330","601.91:14331","601.91:14332","601.91:14333","601.91:14334","601.91:14335","601.91:14336","601.91:14337","601.91:14338","601.91:14339","601.91:14340","601.91:14341","601.91:14342",
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"601.91:14359","601.91:14360","601.91:14361","601.91:14362","601.91:14363","601.91:14364","601.91:14365","601.91:14366","601.91:14367","601.91:14368","601.91:14369","601.91:14370","601.91:14371","601.91:14372","601.91:14373","601.91:14374",
"601.91:14375","601.91:14376","601.91:14377","601.91:14378","601.91:14379","601.91:14380","601.91:14381","601.91:14382","601.91:14383","601.91:14384",
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"601.91:14417","601.91:14418","601.91:14419","601.91:14420","601.91:14421","601.91:14422","601.91:14423","601.91:14424","601.91:14425","601.91:14426"]}],"xchg":{"date":3230807.233721,"description":"(no description)","name":"YS*5.01*234 LVVF
Q","source":"MELDRUM@CAMP MASTER","version":1.02}}
vity then please respond as though you were using the device or technique.","max":0,"min":0,"questionDisplay":81372,"questionId":8771,"questionText":"Keep your place while reading","required":true,"responseTypeId":1,"responseTypeText":"MCHO
ICE","sequence":50},{"choice":[{"choiceId":5330,"choiceText":"UNSCORED - Patient not interested in activity","ien":100293,"legacyValue":0,"sequence":1},{"choiceId":5331,"choiceText":"NOT difficult","ien":100294,"legacyValue":1,"sequence":2}
,{"choiceId":5332,"choiceText":"SLIGHTLY\/MODERATELY difficult","ien":100295,"legacyValue":2,"sequence":3},{"choiceId":5333,"choiceText":"EXTREMELY difficult","ien":100296,"legacyValue":3,"sequence":4},{"choiceId":5334,"choiceText":"IMPOSSI
BLE","ien":100297,"legacyValue":4,"sequence":5}],"choiceDisplay":81351,"choiceIdentifier":0,"choiceIdentifierIen":42304,"choiceTypeId":15059,"designator":"6.","hint":null,"id":8849,"instrument":295,"introDisplay":81371,"introId":2472,"intro
IBLE","ien":100297,"legacyValue":4,"sequence":5}],"choiceDisplay":81351,"choiceIdentifier":0,"choiceIdentifierIen":42304,"choiceTypeId":15059,"designator":"1.","hint":null,"id":8833,"instrument":295,"introDisplay":81371,"introId":2472,"intr
Text":"For each of the following items select one response to indicate the difficulty level.\r\n||\r\nThese questions relate to reading and near vision activities. Remember if you use\r\na low vision device, adaptive device, or an adaptive
technique to assist with the\r\nactivity then please respond as though you were using the device or technique.","max":0,"min":0,"questionDisplay":81372,"questionId":8784,"questionText":"See photos","required":true,"responseTypeId":1,"respon
seTypeText":"MCHOICE","sequence":60},{"choice":[{"choiceId":5330,"choiceText":"UNSCORED - Patient not interested in activity","ien":100293,"legacyValue":0,"sequence":1},{"choiceId":5331,"choiceText":"NOT difficult","ien":100294,"legacyValue
":1,"sequence":2},{"choiceId":5332,"choiceText":"SLIGHTLY\/MODERATELY difficult","ien":100295,"legacyValue":2,"sequence":3},{"choiceId":5333,"choiceText":"EXTREMELY difficult","ien":100296,"legacyValue":3,"sequence":4},{"choiceId":5334,"cho
iceText":"IMPOSSIBLE","ien":100297,"legacyValue":4,"sequence":5}],"choiceDisplay":81351,"choiceIdentifier":0,"choiceIdentifierIen":42304,"choiceTypeId":15059,
"designator":"7.","hint":null,"id":8846,"instrument":295,"introDisplay":81371,"introId":2472,"introText":"For each of the following items select one response to indicate the difficulty level.\r\n||\r\nThese questions relate to reading and n
ear vision activities. Remember if you use\r\na low vision device, adaptive device, or an adaptive technique to assist with the\r\nactivity then please respond as though you were using the device or technique.","max":0,"min":0,"questionDisp
lay":81372,"questionId":8781,"questionText":"Find something on a crowded shelf","required":true,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":70},{"choice":[{"choiceId":5330,"choiceText":"UNSCORED - Patient not interested in ac
tivity","ien":100293,"legacyValue":0,"sequence":1},{"choiceId":5331,"choiceText":"NOT difficult","ien":100294,"legacyValue":1,"sequence":2},{"choiceId":5332,"choiceText":"SLIGHTLY\/MODERATELY difficult","ien":100295,"legacyValue":2,"sequenc
e":3},{"choiceId":5333,"choiceText":"EXTREMELY difficult","ien":100296,"legacyValue":3,"sequence":4},{"choiceId":5334,"choiceText":"IMPOSSIBLE","ien":100297,"legacyValue":4,"sequence":5}],"choiceDisplay":81351,"choiceIdentifier":0,"choiceId
oText":"For each of the following items select one response to indicate the difficulty level.\r\n||\r\nThese questions relate to reading and near vision activities. Remember if you use\r\na low vision device, adaptive device, or an adaptive
entifierIen":42304,"choiceTypeId":15059,"designator":"8.","hint":null,"id":8843,"instrument":295,"introDisplay":81371,"introId":2472,"introText":"For each of the following items select one response to indicate the difficulty level.\r\n||\r\
nThese questions relate to reading and near vision activities. Remember if you use\r\na low vision device, adaptive device, or an adaptive technique to assist with the\r\nactivity then please respond as though you were using the device or t
echnique.","max":0,"min":0,"questionDisplay":81372,"questionId":8778,"questionText":"Identify medicine","required":true,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":80},{"choice":[{"choiceId":5330,"choiceText":"UNSCORED - Pati
ent not interested in activity","ien":100293,"legacyValue":0,"sequence":1},{"choiceId":5331,"choiceText":"NOT difficult","ien":100294,"legacyValue":1,"sequence":2},{"choiceId":5332,"choiceText":"SLIGHTLY\/MODERATELY difficult","ien":100295,
"legacyValue":2,"sequence":3},{"choiceId":5333,"choiceText":"EXTREMELY difficult","ien":100296,"legacyValue":3,"sequence":4},{"choiceId":5334,"choiceText":"IMPOSSIBLE","ien":100297,"legacyValue":4,"sequence":5}],"choiceDisplay":81351,"choic
eIdentifier":0,"choiceIdentifierIen":42304,"choiceTypeId":15059,"designator":"9.","hint":null,"id":8844,"instrument":295,"introDisplay":81371,"introId":2472,"introText":"For each of the following items select one response to indicate the di
fficulty level.\r\n||\r\nThese questions relate to reading and near vision activities. Remember if you use\r\na low vision device, adaptive device, or an adaptive technique to assist with the\r\nactivity then please respond as though you we
re using the device or technique.","max":0,"min":0,"questionDisplay":81372,"questionId":8779,"questionText":"Tell time","required":true,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":90},{"choice":[{"choiceId":5330,"choiceText":
"UNSCORED - Patient not interested in activity","ien":100293,"legacyValue":0,"sequence":1},{"choiceId":5331,"choiceText":"NOT difficult","ien":100294,"legacyValue":1,"sequence":2},{"choiceId":5332,"choiceText":"SLIGHTLY\/MODERATELY difficul
t","ien":100295,"legacyValue":2,"sequence":3},{"choiceId":5333,"choiceText":"EXTREMELY difficult","ien":100296,"legacyValue":3,"sequence":4},{"choiceId":5334,"choiceText":"IMPOSSIBLE","ien":100297,"legacyValue":4,"sequence":5}],"choiceDispl
technique to assist with the\r\nactivity then please respond as though you were using the device or technique.","max":0,"min":0,"questionDisplay":81372,"questionId":8768,"questionText":"Read newspaper or magazine articles","required":true,
ay":81351,"choiceIdentifier":0,"choiceIdentifierIen":42304,"choiceTypeId":15059,"designator":"10.","hint":null,"id":8851,"instrument":295,"introDisplay":81371,"introId":2530,"introText":"These questions relate to distance visual activities.
Remember if you use\r\na low vision device, adaptive device, or an adaptive technique to assist with the
\r\nactivity then please respond as though you were using the device or technique.","max":0,"min":0,"questionDisplay":81372,"questionId":8786,"questionText":"Read street signs","required":true,"responseTypeId":1,"responseTypeText":"MCHOICE"
,"sequence":100},{"choice":[{"choiceId":5330,"choiceText":"UNSCORED - Patient not interested in activity","ien":100293,"legacyValue":0,"sequence":1},{"choiceId":5331,"choiceText":"NOT difficult","ien":100294,"legacyValue":1,"sequence":2},{"
choiceId":5332,"choiceText":"SLIGHTLY\/MODERATELY difficult","ien":100295,"legacyValue":2,"sequence":3},{"choiceId":5333,"choiceText":"EXTREMELY difficult","ien":100296,"legacyValue":3,"sequence":4},{"choiceId":5334,"choiceText":"IMPOSSIBLE
","ien":100297,"legacyValue":4,"sequence":5}],"choiceDisplay":81351,"choiceIdentifier":0,"choiceIdentifierIen":42304,"choiceTypeId":15059,"designator":"11.","hint":null,"id":8848,"instrument":295,"introDisplay":81371,"introId":2530,"introTe
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about other daily living activities. Remember if you use\r\na low vision device, adaptive device, or an adaptive technique to assist with the\r\nactivity then please respond as though you were using the device or technique.","max":0,"min":0
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"max":0,"min":0,"questionDisplay":81372,"questionId":8777,"questionText":"Groom yourself","required":true,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":170},{"choice":[{"choiceId":5330,"choiceText":"UNSCORED - Patient not inter
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:"19.","hint":null,"id":8850,"instrument":295,"introDisplay":81371,"introId":2532,"introText":"The last set of questions deal with issues of mobility. Remember if you use\r\na low vision device, adaptive device, or an adaptive technique to
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|
