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Practical Information, Guidance & Local Resources for those affected by ME/CFS


Faces in the crowd . . .

“I know what the doctor said, but I can't help but worry about my
child and whether or not I have passed my affliction on to her .”

Only we know . . . the full impact of ME/CFS.

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Share your experiences and knowledge to help fight this dreaded disease.
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There is much to be learned from YOUR struggle with ME/CFS which can assist others to fight the disease. Not the least of which are the medical practitioners and services you found helpful and would recommend to others.

Please take a moment and complete the survey shown below.

The information gathered by the survey will be published on this site in summary form to enable other ME/CFS sufferers and researchers to better understand the disease and its impact as well as the various methods employed to deal with it.

Please note: No personally identifiable information about you will be posted on this site, or otherwise made available to anyone not directly affiliated with ME-CFSKnowledgeCenter.com without your specific written approval.

1. Please indicate your interest in ME/CFS.  
If you have, or have had ME/CFS would you please completre the following:

2. Your Gender:
   
3. Your Age:
   
4. How long have you had ME/CFS?
   
5. What the onset of the illness sudden or gradual?  
   
6. Current Condition:
 
7. For those who are still afflicted, please advise as to your ability to work:
I am able to continue working to support myself on the same schedule as I had prior to my affliction with ME/CFS
I am able to continue working but on a reduced schedule since my affliction with ME/CFS
I am not able to work to support myself
 
8. For those who are still afflicted with ME/CFS please advise as to your financial status:
I am able to financially support myself in the same manner as I did before my affliction with ME/CFS
My ability to financially support myself is significantly diminished from ME/CFS and I DO NOT receive governmental financial assistance
I am unable to financially support myself and I DO receive governmental financial assistance
I am unable to financially support myself and I DO NOT receive governmental assistance
 
9. Would you please indicate the types of medical service professionals you have consulted specifically for your ME/CFS illness?
M.D. (Internist or General Practitioner)
M.D. Specialist - Please specify:
M.D. Specialist - Please specify:
D.O. Nutritionist Psychologist
Physical Therapist Massage Therapist Acupuncturist
Herbalist Pharmacologist  
Other - Please name: Other - Please name:
Other - Please name: Other - Please name:
 
10. Do you have any form of medical insurance coverage?
If yes, please indicate source:
 
11. Would you please provide the names and contact information of any of the above service providers whom you thought were particularly helpful to you and to whom you would refer others? Please list only those with whom you have personally dealt.
Name:
Name:
Service Type:
Service Type:
Contact Info:
Contact Info:
 
 
Name:
Name:
Service Type:
Service Type:
Contact Info:
Contact Info:
 
 
Name:
Name:
Service Type:
Service Type:
Contact Info:
Contact Info:
 
 
 

12.
Have you taken, or are you currently taking, any medications specifically prescribed for your ME/CFS condition by a physician?


If Yes above, would you please identify the prescribed medication(s):


 
13.
Have you taken, or are you currently taking any over the counter medications or nutritional supplements specifically for your ME/CFS condition whether recommended by a medical provider or not?



If, Yes above, would you please list the over the counter medications and/or supplements below?
 
14.
Do you sleep soundly at night?
 
15.
How many hours of sound sleep at night do you get on average?
 
16.
Are there any non-medical activities which you do on a regular basis which you feel have helped relieve your CFS symptoms?
 

17.
Do you follow a routine of daily physical exercise?


If Yes above, please indicate those you do regularly:

Walking
Aerobic exercise
Aqua therapy

Pilates
Yoga
Others (please name below)
 
Please enter your email address:
 
Thank you for completing the survey
 

 

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