NCCN Distress Thermometer

General Information

  • Name * Required
  • Level of Distress

  • Please select the number (10=Extreme distress, 0= No distress) that best describes how much distress you have been experiencing in the past week, including today.
  • Problem List

  • Please indicate if any of the following has been a problem for you in the past week including today. Please select all that apply.
  • Practical Problems
  • Family Problems
  • Emotional Problems
  • Physical Problems
  • Spiritual/Religious concerns