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    STEP 2

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    STEP 3

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    STEP 1

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    STEP 4

    Disability Status

    Communicating

    No difficultySome difficultyA lot of difficultyCan't do at all

    Sight

    No difficultySome difficultyA lot of difficultyCan't do at all

    Hearing

    No difficultySome difficultyA lot of difficultyCan't do at all

    Self-care

    No difficultySome difficultyA lot of difficultyCan't do at all

    Remembering

    No difficultySome difficultyA lot of difficultyCan't do at all

    Walking

    No difficultySome difficultyA lot of difficultyCan't do at all

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    STEP 4

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