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Medical Symptoms Questionnaire (MSQ)

Medical Symptoms Questionnaire (MSQ)

screening

Digital administration of Medical Symptoms Questionnaire (MSQ) to collect structured patient inputs for validated score calculation and clinical follow-up.

Medical Symptoms Questionnaire (MSQ)

Clinical intent

The Medical Symptoms Questionnaire (MSQ) score is an essential functional medicine tool to assess patients initially and then to monitor progress. The higher the symptom score, the more severe the medical condition.

MSQ Scores give information about the body systems involved in the disease and how badly they are affected. This helps the physician to provide priority to critical systems when planning the healing process.

Clinical interpretation

Based on the total score, an interpretation is added:

20 or less is not clinically significant / optimal
20 to 49 indicates mild toxicity
50 to 99 indicates moderate toxicity
100 and above indicates severe toxicity

References

[1] https://thevitalityclinic.co.uk/videos/medical-symptoms-questionnaire/

Pathway

initialization

initialization

Initial trigger context for participant details.

survey

Medical Symptoms Questionnaire (MSQ) questionnaire

The Medical Symptoms Questionnaire (MSQ) score is an essential functional medicine tool to assess patients initially and then to monitor progress. The higher the symptom score, the more severe the medical condition.

email

Send questionnaire email

Sends an email explaining the questionnaire and including the survey link.

wait

Wait for questionnaire submission

Waits for questionnaire submission event.

Press enter or space to select a node. You can then use the arrow keys to move the node around. Press delete to remove it and escape to cancel.

Press enter or space to select an edge. You can then press delete to remove it or escape to cancel.

Form preview

Interactive preview of the questionnaire. Not for clinical use. Responses are not stored.

Medical Symptoms Questionnaire (MSQ) Questionnaire

Please complete this questionnaire. Your responses help your clinical team assess your symptoms and monitor progress over time.

Head - Headaches

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Head - Faintness

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Head - Dizziness

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Head - Insomnia

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Eyes - Watery or itchy eyes

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Eyes - Swollen, reddened or sticky eyelids

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Eyes - Bags or dark circles under eyes

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Eyes - Blurred or tunnel vision

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Ears - Itchy ears

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Ears - Earaches, ear infections

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Ears - Drainage from ear

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Ears - Ringing in ears, hearing loss

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Nose - Stuffy nose

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Nose - Sinus problems

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Nose - Hay fever

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Nose - Sneezing attacks

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Nose - Excessive mucus formation

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Mouth/throat - Chronic coughing

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Mouth/throat - Gagging, frequent need to clear throat

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Mouth/throat - Sore throat, hoarseness, loss of voice

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Mouth/throat - Swollen or discolored tongue, gums, lips

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Mouth/throat - Canker sores

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Skin - Acne

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Skin - Hives, rashes, dry skin

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Skin - Hair loss

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Skin - Flushing, hot flashes

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Skin - Excessive sweating

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Heart - Irregular or skipped heartbeat

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Heart - Rapid or pounding heartbeat

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Heart - Chest pain

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Lungs - Chest congestion

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Lungs - Asthma, bronchitis

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Lungs - Shortness of breath

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Lungs - Difficulty breating

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Digestive tract - Nausea, vomiting

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Digestive tract - Diarrhea

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Digestive tract - Constipation

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Digestive tract - Bloated feeling

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Digestive tract - Belching, passing gas

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Digestive tract - Heartburn

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Digestive tract - Intestinal/stomach pain

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Joints/muscle - Pain or aches in joints

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Joints/muscle - Arthritis

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Joints/muscle - Stiffness or limitation of movement

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Joints/muscle - Pain or aches in muscles

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Joints/muscle - Feeling of weakness or tiredness

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Weight - Binge eating/drinking

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Weight - Craving certain foods

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Weight - Excessive weight

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Weight - Compulsive eating

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Weight - Water retention

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Weight - Underweight

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Energy/activity - Fatigue, sluggishness

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Energy/activity - Apathy, lethargy

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Energy/activity - Hyperactivity

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Energy/activity - Restlessness

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Mind - Poor memory

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Mind - Confusion, poor comprehension

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Mind - Poor concentration

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Mind - Poor physical coordination

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Mind - Difficulty in making decisions

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Mind - Stuttering or stammering

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Mind - Slurred speech

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Mind - Learning disabilities

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Emotions - Mood swings

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Emotions - Anxiety, fear, nervousness

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Emotions - Anger, irritability, aggressiveness

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Emotions - Depression

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Other - Frequent illness

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Other - Frequent or urgent urination

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe

Other - Genital itch or discharge

Never or almost never have the symptom

Occasionally have it, effect is not severe

Occasionally have it, effect is severe

Frequently have it, effect is not severe

Frequently have it, effect is severe