Thank you for taking our Chronic Migraine Quiz.

Your answers aren’t consistent with Chronic Migraine symptoms. Chronic Migraine is defined as having 15 or more headache days each month, with migraine on at least 8 of those days, and each headache lasting 4 hours or longer.

It’s important to continue to keep track of your headaches and migraine attacks.

If you feel like they are becoming more frequent or more severe, you should speak to your doctor as soon as possible to determine the cause and potential treatment plans.

Try our Headache & Migraine Tracker

You're all done!

Question 1 of 7

Diagnosed with Chronic Migraine

Tell us about yourself...   

Have you been diagnosed with Chronic Migraine?

Question 2 of 7

Question 2 Image

What medication(s) are you currently taking for your headaches and migraine attacks?

Select all that apply.

Please make a selection.

Question 3 of 7

Question 3 Image

Think back to before you began your current medication(s). How often did you have headaches or migraine attacks?

Question 4 of 7

Question 4 Image

In the last month, how many days did your headaches and migraine attacks impact your daily life? For example, did you have to cancel any plans or miss work?

Question 5 of 7

Question 5 Image

Do your headaches or migraine attacks typically last longer than 4 hours?

Question 6 of 7

Question 6 Image

When you have a headache, how often do you have any of the following symptoms: nausea or vomiting, sensitivity to light or sound, seeing “spots,” or pain on one side of the head behind the eye or eyeball?

Question 7 of 7

Question 7 Image

Have you spoken to your doctor about how often you have headaches and migraine attacks and how they affect you?

You're all done!

Congratulations on completing our Chronic Migraine Quiz and taking this important step!

Next, download your answers and share with your doctor.

Talk about the number of headaches and migraine attacks you have and how they affect your life. If your doctor diagnoses you with Chronic Migraine, stand up to it and ask about preventing headaches and migraine attacks before they even start with BOTOX®.

Please provide appropriate value in each field's default value property as per Analytics Tech Specs

Form Name:

Form Category:

Account Management, Contact, Interactions, Quiz, Registration, Services

 

Form Sub-Category:

Password Resets, Login, Profile, Representative, Contact Us, Polls, Social Share, Doctor Discussion Guide, Dosing Guide, Symptom Checker, Knowledge Assessment, Event, More Info, Sign Up, Saving Card, Benefit Verification, Benefit Enrollments, Medical Exception, Injection Form, Share a Story

Form MVA Name:

Form MVA Type:

Download, Form, Link, Share, Tool, Video

Form MVA Tier:

Form MVA Category:

Savings Card, Insurance, Symptom Journal, Test Score Tracker, Condition Information, Doctor Discussion Guide, Dosing Information, Enrollment Form, Flashcard, Medical Exception, Patient Counseling Guide, Savings Card, Symptom Journal, Doctor Discussion Guide, Doctor Search, Dosage Calculator, Enroll, Med Reminders, Quick Poll, Resource Request, Symptom Quiz, UGC Submission, Contact Rep, Savings Card, Social Share, App Store, More Info, Patient Resources, Share Information, Share Results, Submit a Story, Assessment Tool, Benefits Verification, Carousel, Initiation, Myth versus Fact, Workaround Quiz, Formulary Tool, Image Expand, Medical Exception, Q And A, Slider, Administration Instructions, Condition Information, Insurance, Inventory, Mechanism of Action, Patient Story, Product Overview, Program Overview, Injection Training, Other

 

Form PII Field Names for Masking:

Form MVA Initialize QA:

Form Analytics Payload: