HOROWITZ/MSIDS 38 POINT SYMPTOM CHECKLIST

Think about how you have been feeling over the previous month and how often you have been bothered by the following:

Think about how you have been feeling over the previous month and how often you have been bothered by the following:

Think about how you have been feeling over the previous month and how often you have been bothered by the following:

Think about how you have been feeling over the previous month and how often you have been bothered by the following:

Think about how you have been feeling over the previous month and how often you have been bothered by the following:

Think about how you have been feeling over the previous month and how often you have been bothered by the following:

Now, please mark each incident you can answer yes to with the following questions:

Project Lyme encourages you to locate a knowledgeable Lyme disease specialist in your area by consulting this Provider Search through the International Lyme and Associated Diseases Society. Submit the form below to receive a copy of your results to share with your medical provider.