MECFS Survey

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ME/ CFS Survey 2023

Section 1

To enable us to fully assess the results of this survey can you please let us know how severely you are currently affected by ME or CFS:

Please tick one:

Mild: mobile and able to self-care, able to do light domestic tasks with difficulty, likely to be in work/education, but stopped all leisure pursuits and need to take time off or use weekends to rest Moderate: reduced mobility, restricted in all aspects of daily living, symptoms fluctuate. Usually stopped work/education, need rest/sleep during the day and experience poor quality sleep at night Severe: significantly reduced mobility, spend much of the day in bed, rarely able to leave the home, minimal daily tasks only, severe cognitive difficulties, sensitive to light and noise and severe prolonged after effects from effort Very severe: unable to mobilise or carry out daily tasks, restricted to bed, often unable to tolerate any noise and likely extremely sensitive to light and touch, may be unable to speak or swallow

1. This is:

My first referral to the ME/CFS service Not the first time I have been referred to the ME/CFS service

2a. When I accessed the ME and CFS Service I saw (tick all that apply):

A doctor A therapist Not sure

2b. If you recall their name(s) please enter here:

3. I believe I am being treated for a (tick):

A physical illness A psychological illness A combination of both physical and psychological illness

4a. The report sent back to me was (tick)

Satisfactory Unsatisfactory

4b. Please say why:

My attendance at work

My attendance at education