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Old Seward & Dimond, Anchorage

Dunn St., Juneau

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HEADACHE DISABILITY QUIZ

HEADACHE DISABILITY QUIZ

Step 1 of 28

3%

HEADACHE DISABILITY.

INSTRUCTIONS: PLEASE READ CAREFULLY: The purpose of the scale is to identify difficulties that you may be experiencing because of your headache. Please check off “YES”, “SOMETIMES”, or “NO” to each item. Answer each item as it pertains to your headache only.

You're from Alaska?*
- Yes
- No

Because of my headaches I feel handicapped.*
- Yes
- Sometimes
- No

Because of my headaches I feel restricted in performing my activities.*
- Yes
- Sometimes
- No

No one understands the effect my headaches have on my life.*
- Yes
- Sometimes
- No

I restrict my recreational activities (e.g. sports, hobbies) because of my headaches.*
- Yes
- Sometimes
- No

My headaches make me angry.*
- Yes
- Sometimes
- No

Sometimes I feel that I am going to lose control because of my headaches.*
- Yes
- Sometimes
- No

Because of my headaches I am less likely to socialize.*
- Yes
- Sometimes
- No

My spouse/significant other, or family and friends have no idea what I am going through because of my headaches.*
- Yes
- Sometimes
- No

My headaches are so bad that I feel I am going to go insane.*
- Yes
- Sometimes
- No

My outlook on the world is affected by my headaches.*
- Yes
- Sometimes
- No

I am afraid to go outside when I feel a headache is starting.*
- Yes
- Sometimes
- No

I feel desperate because of my headaches.*
- Yes
- Sometimes
- No

I am concerned that I am paying penalties at work or at home because of my headaches.*
- Yes
- Sometimes
- No

My headaches place stress on my relationships with family or friends.*
- Yes
- Sometimes
- No

I avoid being around people when I have a headache.*
- Yes
- Sometimes
- No

I believe my headaches are making it difficult for me to achieve my goals in life.*
- Yes
- Sometimes
- No

I am unable to think clearly because of my headaches.*
- Yes
- Sometimes
- No

I get tense (e.g. muscle tension) because of my headaches.*
- Yes
- Sometimes
- No

I do not enjoy social gatherings because of my headaches.*
- Yes
- Sometimes
- No

I feel irritable because of my headaches.*
- Yes
- Sometimes
- No

I avoid traveling because of my headaches.*
- Yes
- Sometimes
- No

My headaches make me feel confused.*
- Yes
- Sometimes
- No

My headaches make me feel frustrated.*
- Yes
- Sometimes
- No

I find it difficult to read because of my headaches.*
- Yes
- Sometimes
- No

I find it difficult to focus my attention away from my headaches and on other things.*
- Yes
- Sometimes
- No

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Schedule an Appointment, Receive a One-Hour Massage Certificate!

That’s right! Receive a certificate for a free one-hour massage with one of our highly-trained, professional, and licensed massage therapists for use after your first appointment. You can use it yourself, or give it to one of your family or friends for them to use!

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Location Choice*
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