Brief Fatigue Inventory - NPCRC

1 Date: / / Time:_____Name:_____ _____ _____ Last First Middle InitialBrief Fatigue InventorySTUDY ID# HOSPITAL # F. Enjoyment of life012345678910D. Normal work (includes both work outside the home and daily chores)012345678910C. Walking ability012345678910012345678910B. MoodA. General activity4. Circle the one number that describes how, during the past 24 hours, Fatigue has interfered with your:1. Please rate your Fatigue (weariness, tiredness) by circling the one number that best describes your Fatigue right bad asFatigue you can imagine012345678910012345678910 NoAs bad asFatigue you can imagineE.

2 Relations with other people012345678910012345678910 NoAs bad asFatigue you can imagine Does not interfereCompletely Interferes Does not interfereCompletely Interferes 3. Please rate your Fatigue (weariness, tiredness) by circling the one number thatbest describes your WORST level of Fatigue during past 24 hours. 2. Please rate your Fatigue (weariness, tiredness) by circling the one number thatbest describes your USUAL level of Fatigue during past 24 1997 The University of Texas M. D. Anderson Cancer CenterAll rights reserved. Throughout our lives, most of us have times when we feel very tired or fatigued.

3 Have you felt unusually tired or fatigued in the last week? Yes No Does not interfereCompletely Interferes Does not interfereCompletely Interferes Does not interfereCompletely Interferes Does not interfereCompletely Interferes