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Please indicate your age and sex and answer the three questions. Your identity will not in any way be reflected or registered. Confidentiality will be observed. Thanks.
 
 
 
Age (Please indicate)
   
 
 
 
Sex (Please indicate)
 
 
 
How often do you usually experience headache in a week?
 
Once or twice a week
 
More than twice a week
 
I seldom experience headache
 
 
 
How long do you usually have headache?
 
It usually lasts for several minutes only
 
It usually lasts for several hours
 
It usually lasts for a day
 
It usually lasts for several days
 
 
 
If you are to rate the pain during a headache in a scale of 1-10 with 10 as the most painful, what would it usually be?
 
1-3
 
4-6
 
7-10
 
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