Mini Q Gap™ Survey Instructions

Timing
Please set aside approximately 5 to 15 minutes to complete all the questions, depending on if you want to watch the videos. The entire survey should be finished in one sitting.

How To Respond
The Mini Q Gap™ asks you whether you currently or in the past year have experienced any of 10 symptoms.

If you respond with "Never/Almost Never", just check that box and move to the next question.
If you do experience a symptom, you will need to also respond how intense it is:

Here are some guidelines to help you:

DO NOT ignore symptoms you experience only under specific conditions (for example, during a bout of influenza) or at certain times of the year (such as seasonal allergies), no matter what the cause.

DO reply the actual symptom experience even though you may be actively receiving treatment for a condition. The fact that you're being treated is good but your symptoms should ideally be in better control to improve your quality of life.

Guidelines for Frequency of Symptoms

How often do you experience a symptom?

N/A - not applicable
Almost never - never occurs or, never more than once or twice a year
Occasional - occurs some of the time - less than 6 times a year
Often - occurs most of the time - almost every week
Almost always - present all of the time

Guidelines for Intensity of Symptoms

How severe are the symptoms when you typically experience them?

Mild - Noticeable, but does not affect day-to-day functioning in any way
Moderate - Sufficiently irritating to require relief; moderately affects day-to-day functioning
Severe - Severe enough to seek or have received medical attention; meaningfully affects day-to-day life