Lumbar Risk Self-Assessment Tool

Non-Specific Low Back Pain Questionnaire

Instructions for Patients

Please read each question carefully and select the one option that best describes how you feel right now or over the past week. There are no right or wrong answers — please answer honestly.

⏱ Estimated time: 5 minutes
Patient Information
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Questionnaire

Response Submitted

Thank you. Your responses have been recorded and will be reviewed by your physiotherapist.

This tool is for use under physiotherapy clinical supervision and does not replace professional clinical assessment.