Cognitive Errors Questionnaire, CFQ Test - the question form

Questions: 25 · 5 minutes
1. Do you have to read something again because you did not take it in the first time?
Very often
Often
Sometimes
Very rarely
Never
2. Do you forget what you went to look for?
1 – Very often
2 – Often
3 – Sometimes
4 – Very rarely
5 – Never
3. Do you fail to notice signposts on the road (e.g., a pedestrian crossing)?
Very often
Often
Sometimes
Very rarely
Never
4. Do you find you hesitate when deciding which direction is left or right?
1 – Very often
2 – Often
3 – Sometimes
4 – Very rarely
5 – Never
5. Do you bump into people?
1 – Very often
2 – Often
3 – Sometimes
4 – Very rarely
5 – Never
6. Do you forget to switch off the gas, lock the door, etc.?
Very often
Often
Sometimes
Very rarely
Never
7. Do you fail to remember the name of someone you have met?
Very often
Often
Sometimes
Very rarely
Never
8. Do you find that, after saying something, you realize you have said it before?
Very often
Often
Sometimes
Very rarely
Never
9. Do you fail to hear people speaking to you when you are doing something else (e.g., working)?
Very often
Often
Sometimes
Very rarely
Never
10. Do you lose your temper and then immediately deny it?
1 – Very often
2 – Often
3 – Sometimes
4 – Very rarely
5 – Never
11. Have you left important letters (messages) unanswered for several days?
1 – Very often
2 – Often
3 – Sometimes
4 – Very rarely
5 – Never
12. Do you forget a turn on a route you know well but use only rarely?
1 - Very often
2 - Often
3 - Sometimes
4 - Very rarely
5 - Never
13. Do you find you do not notice something you need in a shop, even though it is right in front of you?
Very often
Often
Sometimes
Very rarely
Never
14. Have you ever surprised yourself by using an appropriate phrase?
1 – Very often
2 – Often
3 – Sometimes
4 – Very rarely
5 – Never
15. Do you feel you have difficulty making decisions?
Very often
Often
Sometimes
Very rarely
Never
16. Do you forget appointments you have arranged?
1 – Very often
2 – Often
3 – Sometimes
4 – Very rarely
5 – Never
17. Do you forget things (e.g., a pencil, a book, etc.)?
1 – Very often
2 – Often
3 – Sometimes
4 – Very rarely
5 – Never
18. Do you accidentally throw away something you meant to keep, or keep something you meant to throw away (for example, throw away a full matchbox or put a used match back in the box)?
1 – Very often
2 – Often
3 – Sometimes
4 – Very rarely
5 – Never
19. Do you fall asleep when you should be listening?
Very often
Often
Sometimes
Very rarely
Never
20. Do you forget people’s names?
Very often
Often
Sometimes
Very rarely
Never
21. Do you start doing something planned at home and then suddenly switch to something else?
1 – Very often
2 – Often
3 – Sometimes
4 – Very rarely
5 – Never
22. Do you find yourself unable to find the right word when talking?
1 – Very often
2 – Often
3 – Sometimes
4 – Very rarely
5 – Never
23. Do you forget to buy something you went to the store for?
Very often
Often
Sometimes
Very rarely
Never
24. Have you dropped things without noticing?
Very often
Often
Sometimes
Very rarely
Never
25. Do you find you cannot find the right word when talking?
1 – Very often
2 – Often
3 – Sometimes
4 – Very rarely
5 – Never
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