CIRS Symptom Assessment

This assessment evaluates the symptoms commonly associated with Chronic Inflammatory Response Syndrome (CIRS) using Dr. Shoemaker's diagnostic criteria.

Please select any symptoms you have experienced recently or are currently experiencing. Your results will help determine if your symptom pattern aligns with CIRS.

This questionnaire is 13 questions and should only take a minute to complete.

Are you experiencing fatigue or weakness?

Do you have headaches?

Do you have aches or cramps?

Do you have unusual sharp, clawing, electrical or icepick pain(s)?

Do you experience light sensitivity; red eyes; blurring, tearing?

Do you experience SOB; cough; sinus issues?

Do you suffer from abdominal pain, secretory diarrhea; bile acid reflux?

Do you have joint pain or morning stiffness?

Do you have issues with memory, concentration, word assimilation, confusion, or disorientation?

Do you experience any of the following: mood swings; appetite swings, sweats; temperature regulation (hypothalamic functioning)?

Do you experience any of the following: thirst; frequent urination; static shocks?

Do you experience numbness, tingling, and/or taste abnormalities?

Do you ever experience vertigo, tremors and/or skin sensitivity to light touch?