When you have headaches, how often is the pain severe?
Never Rarely Sometimes Very Often Always
How often do headaches limit your ability to do usual daily activities including household work, school or social activities?
Never Rarely Sometimes Very Often Always
When you have a headache, how often do you wish you could lie down?
Never Rarely Sometimes Very Often Always
In the past 4 weeks, how often have you felt too tired to do work or daily activities because of your headaches?
Never Rarely Sometimes Very Often Always
In the past 4 weeks, how often have you felt fed up or irritated because of your headaches?
Never Rarely Sometimes Very Often Always
In the past 4 weeks, how often did your headaches limit your ability to concentrate on your work or daily activities?
Never Rarely Sometimes Very Often Always

This test is not intended to offer medical advice regarding medical diagnosis or treatment. You should talk to your healthcare provider for advice specific to your situation.