Version June 2024
| 1. How would you describe the overall level of fatigue/tiredness you have experienced? |
| none | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | very severe |
| 2. How would you describe the overall level of AS neck, back, or hip pain you have had? |
| none | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | very severe |
| 3. How would you describe the overall level of pain/swelling you have had in joints other than neck, back, and hips? |
| none | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | very severe |
| 4. How would you describe the level of discomfort you have had from an area tender to touch or pressure? |
| none | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | very severe |
| 5. How would you describe the level of morning stiffness you have had from the time you wake up? |
| none | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | very severe |
| 6. How long does your morning stiffness last from the time you wake up? |
| 0 (0 hours) | 1 | 2 | 3 | 4 | 5 (1 hour) | 6 | 7 | 8 | 9 | 10 (2 or more hours) |
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