The Fatigue Severity Scale (FSS) is a well-documented method of evaluating the impact of fatigue has on an individuals life.
The FSS questionnaire contains nine statements that rate the severity of your fatigue symptoms. Read each statement and circle a number from 1 to 7, based on how accurately it reflects your condition during the past week and the extent to which you agree or disagree that the statement applies to you.
A low value (e.g., 1); indicates strong disagreement with the statement, whereas a high value (e.g., 7); indicates strong agreement
First Name
Last Name
DATE:
5
| FSS Questionnaire | |||||||
| During the past week, I have found that: | Disagree <—-> Agree | ||||||
| My motivation is lower when I am fatigued. | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
| Exercise brings on my fatigue. | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
| I am easily fatigued. | 1 | 2 | 3 | 4 | 6 | 7 | |
| Fatigue interferes with my physical functioning. | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
| Fatigue causes frequent problems for me. | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
| My fatigue prevents sustained physical functioning. | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
| Fatigue interferes with carrying out certain duties and responsibilities. | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
| Fatigue is among my three most disabling symptoms | 1 | 2 | 3 | 4 | 6 | 7 | |
| Fatigue interferes with my work, family, or social life. | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
| Total Score: | |||||||
5
Copyright Lauren B. Krupps.