Quality of Life Assessment (4-Domain Model)

What is this test?
This assessment evaluates an individual's overall quality of life across four key domains: physical health, psychological well-being, social relationships, and environmental conditions.

Domains measured:
- Physical Health
- Psychological Well-being
- Social Relationships
- Environment

How to administer:
Rate each item based on your experience over the past few weeks.

Response scale:
1 = Very Poor
2 = Poor
3 = Neutral
4 = Good
5 = Very Good

Scoring:
Each domain is scored separately and averaged.

Interpretation:
Higher scores indicate better quality of life in that domain.





Quality of Life Report

Name:

Age: