Physical and Body Symptoms Test

1. Stomach pain
Not bothered at allBothered a littleBothered a lot

2. Back pain
Not bothered at allBothered a littleBothered a lot

3. Pain in your arms, legs, or joints (knees, hips, etc.)
Not bothered at allBothered a littleBothered a lot

4. Headaches
Not bothered at allBothered a littleBothered a lot

5. Chest pain
Not bothered at allBothered a littleBothered a lot

6. Dizziness
Not bothered at allBothered a littleBothered a lot

7. Fainting spells
Not bothered at allBothered a littleBothered a lot

8. Feeling your heart pound or race
Not bothered at allBothered a littleBothered a lot

9. Shortness of breath
Not bothered at allBothered a littleBothered a lot

10. Constipation, loose bowels, or diarrhea
Not bothered at allBothered a littleBothered a lot

11. Nausea, gas, or indigestion
Not bothered at allBothered a littleBothered a lot

12. Feeling tired or having low energy
Not bothered at allBothered a littleBothered a lot

13. Trouble sleeping
Not bothered at allBothered a littleBothered a lot