Please answer the questions based on the type of headaches that interfere most with your daily activities.

When you have headaches, do you have:

		Never	Sometimes	Always
	- Moderate to severe pain?
	- Pulsating, pounding, or throbbing pain?
	- Worse pain on one side of your head?
	- Worse pain when you move or bend over?
		Never	Rarely	Usually
	- Nausea or vomiting?
	- Sensitivity to or are bothered by light & sound?
			Yes	No
	- In your lifetime have you had at least five headaches with these symptoms?
	- Without treatment, do the headaches last between 4-72 hours?

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