Headache Disability Index

Section 1. INSTRUCTIONS: Please MARK the correct response:

Section 2. INSTRUCTIONS: PLEASE READ CAREFULLY: The purpose of the scale is to identify difficulties that you may be experiencing because of your headaches. Please mark off “YES”, “SOMETIMES”, or “NO” to each item. Answer each item as it pertains to your headaches only.

Section 2. For every 'yes' add 4 points, for every 'sometimes' add 2 points. Do not add any points for any 'no' responses.

Reference: Jacobson Gary P., Ramadan NM, et al., The Henry Ford Hospital Headache Disability Inventory (HDI). Neurology 1994; 44:837-842
FORM 502