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Fibromyalgia functional questionnaire pdf 2026

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  1. Click ‘Get Form’ to open the fibromyalgia functional questionnaire in the editor.
  2. Begin by entering the patient's name and SSN at the top of the form. This information is crucial for identification.
  3. Proceed to question 1, where you will indicate if the patient meets the American Rheumatological criteria for fibromyalgia by selecting 'Yes' or 'No'.
  4. In question 2, list any other diagnosed impairments that may be relevant to the patient's condition.
  5. For question 3, provide a prognosis regarding the patient's condition. Be as detailed as possible.
  6. Continue through questions 4 to 16, carefully selecting or filling in responses based on your best estimate of the patient's symptoms and limitations.
  7. Once completed, review all entries for accuracy before saving or exporting your filled-out questionnaire.

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