<>/Font<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> x��]m����. 3 0 obj WIDESPREAD PAIN INDEX: Five body regions. We provide the FIQ and its Scoring in PDF format in the following 2 files: Fibromyalgia Impact Questionnaire (FIQ) Scoring for FIQ – Link to the pdf A list of FIQ references (in HTML format) can be found at References A patient meets the diagnostic criteria for fibromyalgia if the following 3 conditions are met: 1a. The fibromyalgia impact questionnaire (FIQ): development and validation. Please answer the following questions about your patient’s fibromyalgia and other impairment(s). %PDF-1.5 Annapolis Integrative Medicine Chronic Fatigue/Fibromyalgia Questionnaire Updated: 19-March-2014 1 Alan S Weiss MD Annapolis Integrative Medicine 1819 Bay Ridge Ave Suite 180 Annapolis, MD 21403 AnnapolisIntegrativeMedicine.com Phone: 410-266-3613 Fax: 410-266-6104 Chronic Fatigue/Fibromyalgia Information Questionnaire 1. <>

3. Fibromyalgia Score 12 or more where the Widespread Pain Index is at least 4. eg Widespread Pain Index (WPI) 7 and Symptom Severity Score (SSS) 5 or WPI 4 & SSS 9 . endobj Fibromyalgia Impact Questionnaire (FIQ): Description and Scoring The FIQ is an assessment and evaluation instrument developed to measure fibromyalgia (FM) patient status, progress and … 18:728-733, 1991. 1 0 obj 4 0 obj 2. The WPI score (Part 1) is greater than or equal to 7 AND the SS score (Part 2a & b) is greater than or equal to 5 OR 1b. 2 0 obj

The WPI score (Part 1) is from 3 to 6 AND the SS score (Part 2a & b) is greater than or equal to 9.

Symptoms present for at least 3 months.

Your answers should be based on the evidence in the patient’s file and on your personal contact with and observations of the patient. }zP�B���⻰|�woΞ��]�j��evw}��mw��zHY����,9�����ƒS�v��V�%|�,?�}��|��i`��84-|��7�A�Q�K�y��sz�,2����J�;�����:�?N����-�+v�i4���_�Y�������~���U?� �3�ձ5�.

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