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1. a. Have you heard of the syndrome Fibromyalgia?
Yes, but I am not sure what it is
No (if the answer is No, skip to question #2)
b. Have you or anyone you know been diagnosed with Fibromyalgia?
Yes, I have been diagnosed with Fibromyalgia
Yes, someone I know has been diagnosed with Fibromyalgia
Yes, I am a caregiver for someone who suffers from Fibromyalgia
c. If the answer to question b is "yes", were you (or they) misdiagnosed with other diseases, conditions, or symptoms? (Yes or No)
If yes, what were they?
d. Fibromyalgia signs and symptoms (and co-existing conditions) can consist of: (Check all that apply)
Widespread pain and tender points
Fatigue and sleep disturbances
Irritable bowel syndrome (IBS)
All of the Above
e. Based on your experience, how effective are healthcare providers at recognizing signs and symptoms of fibromyalgia?
Very effective
Not effective
I have no experience and therefore don't know
f. Comment - How has fibromyalgia impacted you or your family (missed work, no family functions, depression/anxiety, lost contact with friends, etc.)?
2. Do you think a man's experience with fibromyalgia is different than female sufferers?
If so, why is it different?
3. What type of healthcare provider would you or your partner contact first about fibromyalgia?
Family physician/Primary Care Physician
Other, please indicate:
4. If you were experiencing some of the symptoms of Fibromyalgia, including widespread pain or tender points, fatigues, sleep disturbances, headaches, etc... How long would you wait before consulting a healthcare provider?
I would contact a doctor right away
1 - 6 months
6 - 12 months
1 - 2 years
3 + years
I would not consult a doctor
5. Where would you go to learn more about fibromyalgia? (Rank 1 to 5)
Patient advocacy / education organization
Online health information / resources
Your healthcare provider or pharmacist
Printed health literature or materials
A family member or friend
Please tell us a little about yourself:
Sex: Male Female
Race: White African American
Asian/Pacific Islander
Marital Status: Married Divorced Widowed
Never been married