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HEADACHE DISABILITY INDEX NAME: DATE: AGE: Scores Total: ; E ; F (100) (52) (48) INSTRUCTIONS: Please CIRCLE the correct response: 1. I have headache: 1 1 per month 2 more than 1 but less than 4 per.

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How to fill out the Headache Disability Index online

The Headache Disability Index is a valuable tool designed to assess the impact of headaches on an individual's daily life. This guide provides clear, step-by-step instructions for users looking to complete this form online efficiently.

Follow the steps to fill out the Headache Disability Index online.

  1. Press the ‘Get Form’ button to obtain the Headache Disability Index document and open it for completion.
  2. Begin by filling in your name, date, and age at the top of the form. Make sure these details are entered accurately as they are essential for identifying your responses.
  3. Provide your total score in the designated area. This score is calculated based on your responses in subsequent sections.
  4. Next, move to the headache frequency section. Circle the option that best describes how often you experience headaches, choosing from the available options: 1 per month, more than 1 but less than 4 per month, or more than one per week.
  5. In the following section, indicate the severity of your headaches by circling either mild, moderate, or severe.
  6. Carefully read through the instructions regarding how to respond to each statement about your headaches. For each item listed, answer with 'YES', 'SOMETIMES', or 'NO'. These responses will help portray the difficulties you experience due to headaches.
  7. Continue to review and respond to each item regarding your experiences related to headaches, marking your answers clearly.
  8. Once you have completed the entire form, review your responses for accuracy before finalizing.
  9. Finally, save your changes, and choose to download, print, or share the completed Headache Disability Index form as needed.

Complete your Headache Disability Index online to better understand the impact of your headaches on daily life.

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Related links form

IRS Instruction SS-4 2011 IRS Instruction W-2 & W-3 2018 IRS Instruction W-2 & W-3 2017 IRS Instruction W-2 & W-3 2016

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The examination should target areas identified as abnormal during the headache history. The general physical examination should include vital signs, funduscopic and cardiovascular assessment, and palpation of the head and face. A complete neurologic examination is essential, and the findings must be documented.

The four-point pain scale (none, mild, moderate, severe) and the 11-point pain scale (0 = no pain, 10 = pain as bad as it could be) have been used in migraine studies to assess treatment efficacy.

Answer each question only as it pertains to your headache. SCORING INSTRUCTIONS: Yes = 4 points, Sometimes = 2, No = 0. Using this system, a total score of 10-28 is considered to indicate mild disability; 30-48 is moderate disability; 50-68 is severe disability; 72 or more is complete disability.

The International Headache Society (IHS) recommends the use of headache frequency as the primary outcome measure, usually assessed as headache days per month documented in a headache diary.

HIT is a tool used to measure the impact headaches have on your ability to function on the job, at school, at home and in social situations. Your score shows you the effect that headaches have on normal daily life and your ability to function.

Getting regular exercise, eating healthy, and staying hydrated are basic self-care tasks you can do to ease stress and prevent future headaches. Meditation, yoga, deep breathing, and mindfulness practices can also help.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232