Headaches (Migraine and Tension)

How long ago did your current headaches begin?

When was your most recent headache?

At what age did you have your first headache?

Are you ever completely free of pain?

Do you have more than one type of headache? Please describe them each separately.

How many headaches do you have each month?

How long do the headaches last?

Do you experience any warning signs before the start of a headache? If so, please describe them.

Do your headaches occur on any particular day of the week or time of day?

How would you describe the pain of your most serious headaches?

When you have a headache (and possibly after), does your scalp and face become sensitive to the touch—and do you avoid combing your hair or putting on glasses or jewelry?

Which of these factors seem to contribute to your headaches? Select all that apply.

What parts of the head do you experience pain?

Is there anything else related to treatment that you'd like to ask or discuss with your medical provider?

Do you have a preferred treatment?

Would you like to share anything else with your provider through an upload?

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