1- a) I am bedbound
|
2
|
b) I am housebound and need assistance for many daily tasks
|
14
|
c) I am housebound, but can live on my own
|
3
|
d) I am not housebound, but need to pace myself constantly
|
9
|
e) I live a normal life as long as I don't push myself too much
|
3
|
2- a) My condition is slowly and steadily worsening over the years
|
0
|
b) My condition has stabilized with little to no change over the years
|
0
|
c) My condition is improving on its own
|
0
|
d) My condition is improving with a treatment plan
|
0
|
3- a) I have a treatment plan which worked wonders
|
0
|
b) I have a treatment plan which improved my condition a bit
|
0
|
c) I have a treatment plan which didn't improve my condition at all
|
0
|
d) I don't have a treatment plan but I try to eat and live healthy
|
0
|
e) I don't care about treatment options, diet or lifestyle at all
|
0
|
4- a) My primary complaint is constant mental fog
|
0
|
b) My primary complaint is disabling physical fatigue
|
0
|
c) My primary complaint is pain
|
0
|
d) My primary complaint is PEM
|
0
|
5- a) I am suffering from CFS for over 10 years
|
1
|
b) I am suffering from CFS for 5 to 10 years
|
0
|
c) I am suffering from CFS for 2-3 years
|
0
|
d) I am suffering from CFS for 1-2 years
|
0
|
e) I am suffering from CFS for less than a year
|
0
|
6- a) I can drive with no restrictions
|
0
|
b) I can drive at most for an hour
|
0
|
c) I can drive for 20-30 mins
|
0
|
d) I cannot drive anymore due to mental fog
|
0
|
7- a) I work full time with no restrictions
|
0
|
b) I work full time with a flexible schedule
|
0
|
c) I work part time with many restrictions
|
0
|
d) I cannot work at all
|
1
|
8- a) I am on disability
|
0
|
b) I applied for disability but got denied
|
0
|
c) I applied for disability and waiting for the decision
|
0
|
d) I haven't applied for disability yet, but I am considering it
|
0
|
e) I don't need disability coverage.
|
0
|
9- a) I believe that we are really close to having a cure
|
0
|
b) The cure is at least 5 years away, but there is a lot more research going on now
|
0
|
c-) The cure is 10 years away, because there is not enough funding
|
0
|
d-) The cure is still decades away.
|
0
|