ANEMIA CHECK

Do I Have Anemia?


This questionnaire is an important first step toward improving your health. Your answers to these questions can help your doctor determine whether you have anemia. Please answer every question to the best of your ability, print out your answers, and discuss them with your doctor.
This self-quiz will not provide you with an answer. Only a health care professional can determine whether you have anemia or not.

What's Your Anemia AQ?

1. Have you felt unusually tired or fatigued?
   Yes No
   
2. Have you experienced unusual weakness?
   Yes No
   
3. Have you experienced shortness of breath?
   Yes No
   
4. Have you felt easily confused or lost your concentration?
   Yes No
   
5. Have you felt dizzy or have you fainted?
   Yes No
   
6. Has your skin become unusually pale, including decreased pinkness in your lips, gums, lining of your eyelids, nail beds, and palms?
   Yes No
   
7. Have you experienced a rapid heartbeat?
   Yes No
   
8. Have you been feeling unusually cold?
   Yes No
   
9. Have you been feeling sad or depressed?
   Yes No
   
10. Do you know if your hemoglobin count is between 12 g/dL and 18 g/dL (grams per deciliter) of blood?
    Yes No