Fatigue Severity Scale (FSS) Fatigue Severity Scale Patient first name(Required)Last name(Required)Email(Required) Enter Email Confirm Email Date of Birth(Required)Date(Required) MM slash DD slash YYYY 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. 1 2 3 4 5 6 7 Q2 – Exercise brings on my fatigue. 1 2 3 4 5 6 7 Q3 – I am easily fatigued. 1 2 3 4 5 6 7 Q4 – Fatigue interferes with my physical functioning. 1 2 3 4 5 6 7 Q5 – Fatigue causes frequent problems for me. 1 2 3 4 5 6 7 Q6 – My fatigue prevents sustained physical functioning. 1 2 3 4 5 6 7 Q7 – Fatigue interferes with carrying out certain duties and responsibilities. 1 2 3 4 5 6 7 Q8 – Fatigue is among my most disabling symptoms. 1 2 3 4 5 6 7 Q9 – Fatigue interferes with my work, family, or social life. 1 2 3 4 5 6 7 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 0 1 2 3 4 5 6 7 8 9 10 Rev 8.8.2022CommentsThis field is for validation purposes and should be left unchanged.