| 1. How much have you suffered from the physical symptoms of the urticaria (itch, hives [welts], and or swelling) in the last six weeks? |
Very much
0 |
Much
1 |
Somewhat
2 |
A little
3 |
Not at all
4 |
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| 2. How much was your quality of life affected by the urticaria in the last six weeks? |
Very much
0 |
Much
1 |
Somewhat
2 |
A little
3 |
Not at all
4 |
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| 3. How often was the treatment for your urticaria in the last six weeks, not enough to control your urticaria symptoms? |
Very often
0 |
Often
1 |
Sometimes
2 |
Seldom
3 |
Not at all
4 |
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| 4. Overall, how well have you had your urticaria under control in the last six weeks? |
Not at all
0 |
A little
1 |
Somewhat
2 |
Well
3 |
Very well
4 |
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