Get Horowitz Lyme Questionnaire

The Horowitz Lyme Questionnaire is an essential tool for assessing Lyme disease symptoms and potential risk factors. This guide will provide you with clear, step-by-step instructions on how to fill out the questionnaire online.

Follow the steps to successfully complete the questionnaire.

1. Press the ‘Get Form’ button to access the Horowitz Lyme Questionnaire and open it in your document editor.
2. Begin by entering your last name in the designated field followed by your first name. This ensures the form is personalized to you.
3. In the ‘Date Of Birth’ field, input your birth date to help contextualize your health history.
4. Fill in today’s date in the provided space to document when you are completing the questionnaire.
5. Proceed to Section 1: Symptom Frequency Score. For each symptom listed, select the score that best corresponds to your experience – use the range from 0 (none) to 3 (severe).
6. Once you have completed Section 1, calculate your total symptom frequency score by summing the scores from all fields in this section.
7. In Section 2: Most Common Lyme Symptoms Score, if you rated any symptoms as 3 in Section 1, add 5 additional points for each applicable symptom.
8. For Section 3: Lyme Incidence Score, read each statement and circle the points that apply to you based on your personal experience.
9. In Section 4: Overall Health Score, evaluate your physical and mental health over the past thirty days. Enter the number of days for each category and award yourself points based on the established ranges.
10. Record your total scores from Sections 1, 2, 3, and 4. Add these totals together for your final score, which indicates your likelihood of having a tick-borne disorder.
11. Review the ‘Interpreting the Results’ section for insights based on your final score, and follow the guidance on whether to seek further evaluation from a healthcare provider.
12. Finally, save your changes, and if necessary, download, print, or share the questionnaire as needed.

Complete the Horowitz Lyme Questionnaire online to gain insights into your health.