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Neurology Center of Fairfax

703-876-0800
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    Neurology Center of Fairfax is implementing Patient Connect by Luma as a way for you to complete your forms online before coming to the office.
    You will receive a text from (703) 574-0867 with your appointment confirmation, reminders, and forms link.
    Please call our office with any questions.

Fatigue Severity Scale (FSS)

Fatigue Severity Scale

This field is for validation purposes and should be left unchanged.
Email(Required)
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Please select the number that best describes your experience with the following statements. This refers to your average way of life with in the last week.

1 indicates “strongly disagree” and 7 indicates “strongly agree”

Q1 – My motivation is lower when I am fatigued.
Q2 – Exercise brings on my fatigue.
Q3 – I am easily fatigued.
Q4 – Fatigue interferes with my physical functioning.
Q5 – Fatigue causes frequent problems for me.
Q6 – My fatigue prevents sustained physical functioning.
Q7 – Fatigue interferes with carrying out certain duties and responsibilities.
Q8 – Fatigue is among my most disabling symptoms.
Q9 – Fatigue interferes with my work, family, or social life.

Visual Analogue Fatigue Scale (VAFS)

Please select which describes your general fatigue with 0 being the worst and 10 being normal.

0 = Constant Fatigue >>> 10 = Regular Fatigue
Rev 8.8.2022

Locations

Fairfax Office
3020 Hamaker Ct, Suite 400
Fairfax, VA 22031

703-876-0800 | Fax: 703-876-0866
Reston Office
1830 Town Center Drive, Suite 305
Reston, VA 20190

703-876-0800 | Fax: 703-876-0866
Sleep Diagnostic and Treatment Center
3020 Hamaker Ct, Suite 400
Fairfax, VA 22031

703-876-2850 | Fax: 571-308-1158
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