Provider's Office

The FIQR is the recommended questionnaire for following the progress of patients with a diagnosis of fibromyalgia.

The SIQR is useful for following the progress of most patients with musculoskeletal disorders.

Here are the 21 questions in the FIQR:

1.     Brush or comb your hair

2.     Walk continuously for 20 minutes

3.     Prepare a homemade meal

4.     Vacuum, scrub or sweep floors

5.     Lift and carry a bag full of groceries

6.     Climb one flight of stairs

7.     Change bed sheets

8.     Sit in a chair for 45 minutes

9.     Go shopping for groceries

10.  Fibromyalgia prevented me from accomplishing goals for the week

11.  I was completely overwhelmed by my fibromyalgia symptoms

12.  Please rate your level of pain

13.  Please rate your level of energy

14.  Please rate your  level of stiffness

15.  Please rate the quality of your sleep

16.  Please rate your level of  depression

17.  Please rate your level of memory problems

18.  Please rate your level of anxiety

19.  Please rate your level of tenderness to touch

20.  Please rate your level of balance problems

21.  Please rate your level of sensitivity to loud noises, bright lights, odors and cold

Completion / scoring times: