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, 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 headaches limit your ability to concentrate on work or daily activities?
Never
Rarely
Sometimes
Very Often
Always

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