What best describes the status of your nr-axSpA?
Pick one
What nr-axSpA symptoms have you experienced recently?
Choose all that apply
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Where do you feel pain or stiffness from your nr-axSpA symptoms most frequently?
My overall pain severity is:
No pain
Severe pain
Do you have difficulty completing any of these tasks or movements without assistance?
What changes have you made because of your nr-axSpA symptoms?
What's one personal or physical goal you want to focus on with the help of your rheumatologist?
Some examples: "Go on a road trip with less nr-axSpA back pain.", "Start up my cooking hobby without nr-axSpA getting in the way.", and "Be able to take my dog on morning walks."
Use this checklist to help you and your rheumatologist build a treatment plan that's right for you—and get you closer to your treatment goals.
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Check your inbox for your completed checklist.
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1. I am currently:
You have chosen not to answer this question.
2. Recently, I've experienced:
3. I feel pain and stiffness most often in:
My overall pain severity scale is:
4. Because of my nr-axSpA symptoms, I have difficulty with:
5. Because of my nr-axSpA symptoms, I have made the following changes:
6. A new goal I want to strive for is:
This is not a diagnostic tool. Discuss results with your rheumatologist.
Has the status of your nr-axSpA changed?
you have not answerwed this question
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