Symptom Survey

Please rate the intensity and frequency of your symptoms using the scale of symptom points listed below. Score every symptom based on your average experience weekly over the last month.

0 = NEVER or RARELY have this symptom.
1 = Was MILD and OCCASIONAL (1 time per week or less)
2 = Was MILD and FREQUENT (2 or more times per week)
3 = Was SEVERE and OCCASIONAL (1 time per week or less)
4 = Was SEVERE and FREQUENT (2 or more times per week)