Quality of Life · 8 Domains · Research Gold Standard

SF-36 Health Survey Calculator

Complete all 36 questions to score Physical Functioning, Role Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role Emotional, and Mental Health domains with radar chart and EMR documentation.

Clinically reviewed by Dr. Nikhil Mahajan, PT, MPT  ·  Jan 15, 2025
Physical Functioning
Role Physical
Bodily Pain
General Health
Vitality
Social Functioning
Role Emotional
Mental Health

For each question, choose the response that best describes how you have been feeling over the past 4 weeks. Answer all 36 questions. There are no right or wrong answers.

Answered 0 /36
Physical —
Mental —
Overall — /100
General Health Personal evaluation of overall health
1 In general, would you say your health is:
Health Change
2 Compared to one year ago, how would you rate your health in general now?
Physical Functioning Ability to perform a range of physical activities
3 Vigorous activities — running, lifting heavy objects, participating in strenuous sports:
4 Moderate activities — moving a table, pushing a vacuum cleaner, bowling, playing golf:
5 Lifting or carrying groceries:
6 Climbing several flights of stairs:
7 Climbing one flight of stairs:
8 Bending, kneeling, or stooping:
9 Walking more than a mile:
10 Walking several blocks:
11 Walking one block:
12 Bathing or dressing yourself:
Role Physical Work/activity limitations due to physical health
13 Cut down the amount of time you spent on work or other activities (due to physical health):
14 Accomplished less than you would like (due to physical health):
15 Were limited in the kind of work or other activities (due to physical health):
16 Had difficulty performing work or other activities (due to physical health — required extra effort):
Role Emotional Work/activity limitations due to emotional problems
17 Cut down the amount of time you spent on work or other activities (due to emotional problems):
18 Accomplished less than you would like (due to emotional problems):
19 Didn't do work or other activities as carefully as usual (due to emotional problems):
Social Functioning Interference of health with social activities
20 During the past 4 weeks, to what extent has your physical health or emotional problems interfered with your normal social activities with family, friends, neighbours, or groups?
Bodily Pain Pain intensity and interference with activities
21 How much bodily pain have you had during the past 4 weeks?
22 During the past 4 weeks, how much did pain interfere with your normal work (including both work outside the home and housework)?
Vitality Energy levels and fatigue
23 Did you feel full of pep?
Mental Health Psychological well-being and emotional state
24 Have you been a very nervous person?
25 Have you felt so down in the dumps that nothing could cheer you up?
26 Have you felt calm and peaceful?
Vitality Energy levels and fatigue
27 Did you have a lot of energy?
Mental Health Psychological well-being and emotional state
28 Have you felt downhearted and blue?
Vitality Energy levels and fatigue
29 Did you feel worn out?
Mental Health Psychological well-being and emotional state
30 Have you been a happy person?
Vitality Energy levels and fatigue
31 Did you feel tired?
Social Functioning Interference of health with social activities
32 During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting friends, relatives)?
General Health Personal evaluation of overall health
33 I seem to get sick a little easier than other people:
34 I am as healthy as anybody I know:
35 I expect my health to get worse:
36 My health is excellent:
0 of 36 questions answered

SF-36 Domain Reference — US Population Norms

Domain Items US Norm (mean) Low Score Indicates High Score Indicates
Physical Functioning (PF)3–12 (10 items)~84Limited by health in all physical activitiesPerforms all physical activities without limitations
Role Physical (RP)13–16 (4 items)~81Problems with work due to physical healthNo problems with work due to physical health
Bodily Pain (BP)21–22 (2 items)~75Very severe and extremely limiting painNo pain or limitations due to pain
General Health (GH)1, 33–36 (5 items)~72Evaluates personal health as poor and likely to declineEvaluates personal health as excellent
Vitality (VT)23, 27, 29, 31 (4 items)~61Feels tired and worn out all of the timeFeels full of pep and energy all of the time
Social Functioning (SF)20, 32 (2 items)~84Extreme and frequent interference with normal social activitiesPerforms normal social activities without interference
Role Emotional (RE)17–19 (3 items)~81Problems with work due to emotional problemsNo problems with work due to emotional problems
Mental Health (MH)24–26, 28, 30 (5 items)~75Feelings of nervousness and depression all of the timeFeels peaceful, happy, and calm all of the time

What is the SF-36 Health Survey?

The SF-36 (Short Form-36 Health Survey) is a 36-item patient-reported questionnaire developed by Ware and Sherbourne (1992) as part of the Medical Outcomes Study (MOS). It is the most widely used health-related quality of life (HRQoL) instrument in the world, translated into over 50 languages and used in more than 4,000 published studies. The SF-36 measures eight dimensions of health, producing domain scores from 0 (worst health) to 100 (best health), plus two component summary scores: the Physical Component Summary (PCS) and the Mental Component Summary (MCS).

The 8 SF-36 Domains Explained

  • Physical Functioning (10 items): Captures limitations in performing a range of physical activities — from vigorous activities like running to basic self-care like bathing. The highest-weighted domain for the PCS.
  • Role Physical (4 items): Assesses how much physical health problems interfere with work and daily activities — including time spent, accomplishments, and type of work limitation.
  • Bodily Pain (2 items): Measures pain intensity and the degree to which pain interferes with normal work inside and outside the home.
  • General Health (5 items): Patient's evaluation of current health, health outlook, and resistance to illness — a personal global health assessment.
  • Vitality (4 items): Energy level and fatigue — measures feeling full of pep and energy vs. feeling worn out and tired.
  • Social Functioning (2 items): Extent to which physical or emotional problems interfere with normal social activities with family, friends, and community.
  • Role Emotional (3 items): How much emotional problems (depression, anxiety) interfere with work and daily activities — including time, accomplishments, and carefulness.
  • Mental Health (5 items): General mental health including anxiety, depression, behavioral-emotional control, and positive affect.

Physical Component Summary (PCS) vs Mental Component Summary (MCS)

The 8 domains aggregate into two higher-order component summaries:

  • PCS (Physical Component Summary): Primarily reflects Physical Functioning, Role Physical, Bodily Pain, and General Health. US norm = 50 (on standardized T-score scale). Values below 40 indicate significant physical impairment.
  • MCS (Mental Component Summary): Primarily reflects Vitality, Social Functioning, Role Emotional, and Mental Health. US norm = 50. Values below 40 indicate significant mental health impairment.

SF-36 vs SF-12 vs SF-8

  • SF-36 (36 items): Full version — provides all 8 domain scores + PCS + MCS. Best for detailed clinical assessment and research.
  • SF-12 (12 items): Provides PCS and MCS only — no individual domain scores. Best for population surveys and time-limited screening.
  • SF-8 (8 items): Single item per domain — provides a quick overview. Best for large epidemiological studies.
  • RAND-36: Identical items to SF-36 but different scoring for Bodily Pain and General Health domains. Freely available without license for research use.

US Population Norms

The US general population mean scores (from the 1998 MOS normative study) range from approximately 61 (Vitality) to 84 (Social Functioning) across domains. Scores below 50 on norm-based scoring indicate health status below the US population average. Disease-specific norms are available for diabetes, heart failure, COPD, and other chronic conditions for more relevant comparison.

Clinical Applications

  • Chronic pain — Tracks quality of life impact beyond pain intensity alone; documents PCS impairment for insurance authorization
  • Orthopedic surgery outcomes — Pre and post-operative QoL documentation for joint replacement, spine surgery
  • Cardiac rehabilitation — Monitors physical and mental health recovery
  • Oncology — Tracks QoL throughout treatment and survivorship
  • Clinical trials — Primary or secondary endpoint in rehabilitation and pharmaceutical research
Dr. Nikhil Mahajan, PT, MPT Doctor of Physical Therapy · Reviewed January 15, 2025 · View full credentials

Frequently Asked Questions

How long does the SF-36 take to complete?
The SF-36 typically takes 5–10 minutes to complete when administered as a paper or digital self-report questionnaire. Some patients with reading difficulties or lower health literacy may require 15–20 minutes. The abbreviated SF-12 takes approximately 2 minutes. Both should be completed independently by the patient without clinician coaching on specific responses.
What is the difference between SF-36 and RAND-36?
The SF-36 and RAND-36 use identical questions but differ in scoring algorithms for two domains: Bodily Pain and General Health. RAND-36 is freely available for research use without a license; SF-36 requires a license from QualityMetric/Optum for commercial use. For clinical practice, the differences are minimal. Our calculator uses standard SF-36 domain scoring methodology.
Can the SF-36 be used to diagnose depression or other conditions?
No. The SF-36 is a Health-Related Quality of Life (HRQoL) measure — it tracks the patient's perception of how health affects functioning and well-being. It does not diagnose specific mental health conditions. Low Mental Health or Role Emotional scores indicate impairment that warrants further clinical assessment (PHQ-9 for depression, GAD-7 for anxiety), but are not diagnostic in isolation.
What timeframe does the SF-36 refer to?
Most SF-36 questions refer to the past 4 weeks — the standard recall period. A 1-week recall version (SF-36 v2 Acute Form) is available for conditions where rapid change is expected. Always instruct patients to answer based on the specified timeframe. For serial assessments tracking treatment response, consistent use of the same recall version is essential for meaningful comparisons.