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Are you female or male?

 Female   Male  


In the past month, how often is it, that you (your),
(1 as the least; 5 as the most frequent)

 
1 2 3 4 5
1. You always feel exhausted.
2. You cannot feel better even having a rest.
3. You are tired of working.
4. You have experienced headache.
5. You always feel dizzy.
6. Your eyes feel aching and tired.
7. You have experienced sore throat.
8. You have experienced stiff muscles and stiff joints.
9. You have experienced pain in shoulder or neck or waist.
10. You have a heavy, tired feeling in the legs while standing or walking.
11. You find hard to breath while sitting still.
12. You have experienced constipation.
13. You have experienced heart palpitation.
14. You have poor appetite.
15. You have experienced upset stomach.
16. You have experienced abdominal discomfort.
17. You have fever or cold intolerance.
18. You are hard to sleep at night.
19. You are hard to wake up in the morning.
20. You forget things easily.
21. You cannot respond quickly.
22. You are hard to concentrate.
23. You feel stressed and lose interest in your life.
24. You are constantly keyed up or jittery.
25. You have suffered from a cold.

Source From: Somatic Complaints of Subhealth Status Questionnaire. SC-SHs-Q