Chronic Fatigue Syndrome Self Assesment

TEACURRY

AGE

Under 45 years

Insert new answer.

Have you ever been found to have high blood glucose?

Yes

No

SMOKING

Never smoked

Nonsmoker for 5 or more years

Smoker for less than 10 years

Smoker for 10 - 20 years

Smoker for more than 20 years

STRESS LEVEL (personal perception)

I don’t feel stress

I feel stressed 1-2 times per week

I feel stressed most days

I feel stress everyday

Are you able to do only less than 50% of the work you usually do, because of tiredness?

Yes

No

Thank you for taking our survey.

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