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What Colour is Your Headache?

What colour is your headache?

Please take this short survey.

It's a bit of fun but might help future research on headache diagnosis.

If you enter your email address you will receive exclusive notification of results.

Your email address will not be shared with anyone else

Results will be published once 300 responses have been received and analysed.

What Colour is Your Headache?

Please note that all fields followed by an asterisk must be filled in.

What Colour is Your Headache? *
What Colour is Your Headache? *

If Other Colour, please say which one

To analyse this please tell me a bit about you. Are you:

	Male
	Female

Age group

Have you ever seen a Neurologist or Headache Specialist?

	Neurologist
	Headache Specialist
	Never seen a Specialist
	Saw a Specialist not sure what type

Did you ever get a headache diagnosis?

As far as you can remember, what was your headache diagnosis?

	Migraine
	Chronic Migraine
	Cluster Headache
	Sinus Headache
	Headache coming from my neck (cervicogenic headache)
	Tension-type Headache
	Stress Headache
	Ice-pick or Idiopathic Stabbing Headache
	Other

If you said Other - please enter your diagnosis here:

I'll need your email address to send you an exclusive preview of results. Your email address will NOT be given to anybody else.

	Yes
	No

E-mail Address

Country

Please enter the word that you see below.

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