How important is it to you to be able to do this activity/task?

How would you rate the way you do this activity/task now?

How satisfied are you with the way you do this activity/task now?

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.