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SAFFE

A. Do you currently: 1. Go to the store? 2. Prepare simple meals?
B. When you [Activity], how worried are you that you might fall?





C. Do you not [Activity] because you are... that you might fall?





D. Are there other reasons that you do not [Activity]?

Specify:


Specify:

E. What are the reasons that you do not [Activity]?

Specify:

Specify:

F. Compared to 5 years ago, would you say that you [Activity]...