JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Evaluacioni list
Ocena nivoa postignutog efekta nakon tretmana
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Pol
*
Ženski
Muški
Drugo
Uzrast
0 - 15
15 - 25
25 - 35
35 - 45
45 - 55
55 - 65
65 - 75
75+
Clear selection
Metod
Nakon tretmana Lucha T8 ocenite sami koliki je nivo težine svakog od navedenih poremećaja (problema) kod Vas u ovom trenutku, izraženo na skali od 0-10. (0 - ne postoji) (10 - maksimalno)
Bol:
0
1
2
3
4
5
6
7
8
9
10
Clear selection
Stres:
0
1
2
3
4
5
6
7
8
9
10
Clear selection
Napetost (opšta, telesna):
0
1
2
3
4
5
6
7
8
9
10
Clear selection
Anksioznost (unutrašnji nemir):
0
1
2
3
4
5
6
7
8
9
10
Clear selection
Nedostatak energije (slabost, obamrlost):
0
1
2
3
4
5
6
7
8
9
10
Clear selection
Iscrpljenost (umor):
0
1
2
3
4
5
6
7
8
9
10
Clear selection
Nesanica:
0
1
2
3
4
5
6
7
8
9
10
Clear selection
Migrena (glavobolja):
0
1
2
3
4
5
6
7
8
9
10
Clear selection
Drugi simptomi i poremećaji ukoliko postoje na skali od 0-10:
Your answer
Komentar:
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Generator 888 doo MB:21526193 PIB:111708326.
Report Abuse
Forms
