Instructions

0 = Not applicable

1 = Mild symptoms (occurs rarely)

2 = MODERATE symptoms (occurs several times a month)

3 = SEVERE symptoms (occurs almost constantly)

Group 1

Group Two

Group Three

Group Four

Group Five

Group Six

Group Seven (A)

Group Seven (B)

Group Seven (C)

Group Seven (D)

Group Seven (E)

Group Seven (F)

Group Seven Eight