The Migraine Disability Assessment (MIDAS) Questionnaire
INSTRUCTIONS: Please answer the following questions about ALL your headaches you have had over the last 3 months. Write your anwer in the next to each questuon. Write zero if you did not do the activity in the last 3 months. |
| 1. On how many days in the last 3 months did you miss work or school because of your headaches? | _______days |
| 2. How many days in the last 3 months was your productivity at work or school reduced by haft or more because of your headaches? (Do not include days you counted in question 1 where you missed work or school) | _______days |
| 3. On how many days in the last 3 months did you not do household work because of you headaches? | _______days |
| 4. How many days in the last 3 months was your productivity in household work reduced by half or more because of your headaches? (Do not include days you counted in question 3 where yo did not do household work) | _______days |
| 5. On how many days in the last 3 months did you miss family, social, or leisure activities because of your headaches? | _______days |
| A. On how many days in the last 3 months did you have a headaches? ( If a headache lasted more than one day, count each day.) | _______days |
| B. On a scale of 0-10, on average, how painful were these headaches? (where 0 = no pain at all and 10 = pain as bad as it can be) | _______ |
