Skip survey header

Fatigue Assessment

Fatigue Assessment

This survey is designed to assess symptoms of fatigue.
This question requires a valid email address.
Generalized Weakness *This question is required.Please rate the degree of difficulty you have initiating activity (a sense of generalized weakness).
None
Moderate
Extreme
Fatiguability *This question is required.Please rate the degree of difficulty you have maintaining activity (easy fatiguability).
None
Moderate
Extreme
Mental Fatigue *This question is required.Please rate the degree of difficulty you have concentration, memory, and emotional stability (mental fatigue).
None
Moderate
Extreme
Somnolence *This question is required.Please rate the degree of sleepiness you feel when awake (somnolence). How easy is it for you to fall asleep if you are inactive? How sleepy do you feel during the day?
None
Moderate
Extreme
Shortness of Breath *This question is required.Please rate how short of breath you feel during the day? Do you feel you are not able to get enough oxygen?
None
Moderate
Extreme
Muscle Symptoms *This question is required.Please rate the degree of difficulty you have performing specific actions during the day (not getting started but actually completing an action) such as climbing stairs or combing hair, and how severe is any feeling of “heaviness” or “stiffness” in your arms or legs. Try to distinguish between symptoms related to specific muscles from an overall sense of weakness.
None
Moderate
Extreme
CFS Symptoms *This question is required.
Other physical symptoms or historical factors that may be associated with fatiguePlease check any of these that apply to you. Feel free to add comments if you aren't sure how to answer.
Please share anything here that is relevant to understanding your feelings of fatigue. And, at the very least, please describe when (in the past month, six months, years ago, etcetera) and how (all of a sudden, gradually, etcetera) the symptoms developed.
0%