This form is to be completed by all patients commencing treatment under their health insurance. It is to be completed BEFORE your first appointment.

 

MYMOP Measure Yourself Medical Outcome Profile

This is for patients to fill out before initial treatment.
  • Now choose one activity (physical, social or mental) that is important to you, and that your problem makes difficult or prevents you doing. Score how bad it has been in the last week. SCORE WITH 1 AS MILD/ 5 IS EXTREMELY PAINFUL
  • SCORE A SECOND KEY SYMPTOM YOU ARE SUFFERING WITH. 1 IS MILD/ 5 IS EXTREMELY PAINFUL Now consider how bad each symptom is, over the last week, and score it by choosing your chosen number.