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* 1. During how many days each month do you experience migraines?

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* 2. During how many days each month do you take migraine medication?

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* 3. How do you feel about taking migraine medication to treat your symptoms?

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* 4. What is the average pain level you experience?

1 1=Hardly any pain, 10=Unbearable amount of pain 10
i We adjusted the number you entered based on the slider’s scale.

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* 5. Most migraine sufferers are barely able to function during a migraine episode. How would you rate your functional capacity during a migraine?

0 In Percent (100% = ability to function as if no migraine present) 100
i We adjusted the number you entered based on the slider’s scale.

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* 6. How many years have you been experiencing migraines?

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* 7. Specific to your migraines, how many times per year do you see a doctor?

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* 8. Do you feel that doctors are able to help with migraines?

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* 9. Those with migraines spend $5,000, on average, each year to treat their symptoms.If you were able to reduce the number of days that you experienced migraines by at least 25% each month, without taking any medication, what would this be worth to you?

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* 10. How interested are you in trying something different to help reduce your migraine episodes?

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