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1. a. Have you heard of the syndrome Fibromyalgia?
Yes
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
No
c. If the answer to question b is "yes", were you (or they) misdiagnosed with other diseases, conditions, or symptoms? (Yes or No)
Yes
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)
Depression
Headaches
All of the Above
e. Based on your experience, how effective are healthcare providers at recognizing signs and symptoms of fibromyalgia?
Very effective
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?
Yes
No
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
Rheumatologist
Neurologist
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
Age:
Race: White African American
Hispanic/Latino
Asian/Pacific Islander
Other:
Marital Status: Married Divorced Widowed
Never been married