How long have you been experiencing your pain?

Less than 3 months

Over 3 months

General

Did your pain begin around a time of intense stress, trauma, great frustration, or loss – or after an event that triggered intense memories of the above?

Yes

No

Do you have multiple symptoms that are different (shoulder pain AND fatigue; or headaches AND digestive problems AND insomnia; or hip pain AND bladder urgency AND tinnitus)?

Yes

No

Have you been diagnosed with 1) a chronic condition involving biological structural damage or autoimmunity (e.g., nerves, organs or tissues) and/or 2) you have pain that occurs in many different body parts at the same time (hands, lower back, neck, and stomach)?

Yes to both 1 & 2

Yes to 1 but no to 2

No to 1 but yes to 2

Do your symptoms vary in severity without obvious physical changes (some days 3 out of 10 and other days 7 out of 10; or you can walk 2 miles some days and other days only 2 blocks before pain/symptoms develop?

Yes

No

Have you been diagnosed with an autoimmune condition (MS, lupus, rheumatoid arthritis,) or a chronic illness (e.g., ALS, Parkinson's Disease, cancer) with secondary pain linked to physical structures like joints, (beyond age-related changes like spinal disc-bulges or wear and tear degenerative changes) organs or inflammation?

Yes

No

Do you tend to be very self-critical, a perfectionist, overly conscientious, a worrier, a people-pleaser, often insecure/doubtful of yourself, or get easily overwhelmed/angered?

Yes

No

Sometimes

Have you been diagnosed with 1) a chronic condition involving biological structural damage or autoimmunity (e.g., nerves, organs or tissues) and/or 2) you tend to frequently check on, worry about, research, think of ways to escape, feel very frustrated by, or dread your symptoms throughout the day?

Yes to both 1 & 2

Yes to 1 but no to 2

No to 1 but yes to 2

Have you received a confirmed fibromyalgia diagnosis from a specialist?

Yes

No

No official diagnosis, but I meet all the criteria, so I think I have fibromyalgia

Have your symptoms changed over time, migrating to different locations in the body (usually in the right leg, but it has moved to the left; low back pain in the morning, but it moves to upper-back or neck pain in the afternoon?

Yes

No

Sometimes

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