Flinders Fatigue Scale
(to be completed by a subject under supervision of a trained clinician)

DATE: TIME (24hr):


Please indicate the extent that you have felt fatigued (tired, weary, exhausted) over the last two weeks.
Do not indicate feelings of sleepiness (the likelihood of falling asleep).
Please indicate the appropriate response in accordance with your average feelings over this two-week period.

Do you have any of the following: Not at all A little bit Moderately Quite a bit Extremely
0 1 2 3 4 5 6 7 8 9 10
1. Was fatigue a problem for you?
2. Did fatigue cause problems with your everyday functioning (e.g., work, social, family)?
3. Did fatigue cause you distress?
4. How severe was the fatigue you experienced?
5. How much was your fatigue caused by poor sleep?


4. How often did you suffer from fatigue? 0 days/ 1-2 days/ 3-4 days/ 5-6 days/ 7 days/ week week week week week

5. At what time(s) of the day did you typically experience fatigue? (Please tick box(es)) Early morning Late afternoon Mid morning Early evening Midday Late evening Mid afternoon

6. How often did you suffer from fatigue?
7. At what time(s) of the day did you typically experience fatigue? (Please tick box(es))


TEXT FOR YOUR RECORDS

DATA FILE

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Last update: 07/12/2015