Fibromyalgia Questionnaire

Thank you for taking the time to complete this questionnaire.

It will assist us me in understanding you and how to support you.  

All questions / answers are optional.   Click “Submit” at the bottom when you are done. 

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Muscle Pain
Joint Pain
Fatigue
Insomina
Anxiety
Depression
Brain Fog
IBS
Other (please note below)

What would you like to learn more about?

No InterestMild InterestHigh Interest
Education about Fibromyalgia
Education about Symptoms
How to live with fibromyalgia
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Sleep
Diet
Exercise / Movement
Hydration
Relaxation
Breathing
Play
No InterestMild InterestHigh Interest
Healthy Mindset
Finding Inner Peace
Emotional Balance
Energy Healing
Spiritual Connection
Healing Trauma
Healing Negative Life Experiences
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Detoxification
Supplements
Energy Healing
Bionetics
Healing Codes