MIGRAINE PAIN  SURVEY
Last updated  8-26-01 
Reload for Newest Page
Please note: Although it is most unlikely that you will experience any problems responding to this form, certain non-standard browsers will not respond properly. If you experience any difficulties, (or if you are not using a forms-capable browser) contact me by clicking here.... email me
 


 
DO YOU HAVE AN ALASKA SIZE HEADACHE?
WOULD YOU LIKE TO BE A PART OF MY MIGRAINE/SYMPTOMS SURVEY?
I WILL BE PUBLISHING THE RESULTS AT THIS WEB SITE SOON.
 


 

I AM A 
AT WHAT AGE DID YOU EXPERIENCE YOUR FIRST MIGRAINE ATTACK? 
HOW LONG HAVE YOU SUFFERED WITH MIGRAINES?: 
DO YOU HAVE A FAMILY HISTORY OF MIGRAINES? YES NO
IF YOU ANSWERED YES, CHECK THE FAMILY RELATIONSHIP(S):
MOTHERFATHERUNCLEAUNT
GRANDMOTHERGRANDFATHER
BROTHERSISTER
Multiple people may be chosen.
DO YOU EXPERIENCE ANY VISUAL PROBLEMS? 
I EXPERIENCE THESE VISUAL PROBLEMS 
MIGRAINE.
ON WHICH SIDE DO YOU EXPERIENCE YOUR MIGRAINE PAIN? LEFT RIGHT
LIST YOUR THREE WORSE SYMPTOMS:
WHAT DO YOU USE TO HELP THE PAIN? 
WHERE DO YOU APPLY? 
MY MIGRAINE HEADACHES USUALLY LAST FOR  HOURS.
HAVE YOU EVER TRIED THE HERB FEVERFEW? 
IF YOU ANSWERED YES, RATE YOUR RESULTS: 
 


 
THANK YOU FOR PARTICIPATING.
I WILL BE PUTTING THE RESULTS ON THIS PAGE.
If you experience any problems with this page
Email me — Theresa B.

OR YOU MAY

 


 
Here are two great links to other Migraine Pages:

MIGRAINES PERSONALITY PROFILE SURVEY
 


 
DO YOU FEEL LIKE YOU NEED A HOLE IN YOUR HEAD TO RELEASE THE EVIL SPIRITS THAT ARE POSSESSING YOU DURING A MIGRAINE?
CLICK ON THE PICTURE FOR FULL SIZE.
 


 
CLOSE UP

International_Trepanation_Advocacy_Group
 


 
This web page was created and designed by Theresa and Jason B.