Doctor’s Visit Symptom Checklist

Doctor

 

From Phoenix Rising.

 

Dr. Katrina Berne, a clinical psychologist and author who specializes in ME/CFS & fibromyalgia, has developed a comprehensive symptom checklist she advises her patients to complete and take to their doctors. This form should be updated every few months to document your symptoms and your progress. It’s especially helpful in the disability application process.

Please indicate on a scale of 1 to 10 the severity and frequency of each symptom, with 10 being the most severe and frequent. Use the past two months as a general guide. If you do not have the symptom, leave the space blank. (Thanks to Dr. Berne for providing this list.)

 

To read the list, click on the link below:

 

Link to Symptoms List

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