Dizziness Handicap Inventory

Dizziness Handicap Inventory

The purpose of this scale is to identify difficulties that you may be experiencing because of your dizziness.
Name *

First Name Last Name
Primary Clinic *

Please check ALWAYS, NO or SOMETIMES to each question. Answer each question only as it pertains to your dizziness problem. *

Always

Sometimes

P1 - Does looking up increase your problem?

E2 - Because of your problem, do you feel frustrated?

F3 - Because of your problem, do you restrict your travel for business or pleasure?

P4 - Does walking down the aisle of a supermarket increase your problem?

F5 - Because of your problem, do you have difficulty getting into or out of bed?

F6 - Does your problem significantly restrict your participation in social activities, such as going out to dinner, going to movies, dancing or to parties?

F7 - Because of your problem, do you have difficulty reading?

F8 - Does performing more ambitious activities like sports, dancing, and household chores, such as sweeping or putting dishes away; increase your problem?

E9 - Because of your problem, are you afraid to leave your home without having someone accompany you?

E10 - Because of your problem, have you been embarrassed in front of others?

P11 - Do quick movements of your head increase your problem?

F12 - Because of your problem, do you avoid heights?

P13 - Does turning over in bed increase your problem?

F14 - Because of your problem, is it difficult for you to do strenuous housework or yard work?

E15 - Because of your problem, are you afraid people may think you're intoxicated?

F16 - Because of your problem, is it difficult for you to go for a walk by yourself?

P17 - Does walking down a sidewalk increase your problem?

E18 - Because of your problem, is it difficult for you to concentrate?

F19 - Because of your problem, is it difficult for you to walk around your house in the dark?

E20 - Because of your problem, are you afraid to stay home alone?

E21 - Because of your problem, do you feel handicapped?

E22 - Has your problem placed stress on your relationship with members of your family or friends?

E23 - Because of your problem, are you depressed?

F24 - Does your problem interfere with your job or household responsibilities?

P25 - Does bending over increase your problem?

Total Score
Total Functional
Total Emotional
Total Physical
Should be Empty: