Welcome Southcoast Neurology Headache Patients

This page is for headache sufferers who have scheduled a medical visit with the Southcoast neurology center.  The instructions that follow will assist you in completing the headache questionnaire.

Please read these instructions and follow them carefully.

Before you arrive for your medical appointment  you must complete the Headache questionnaire and print out the completed questionnaire (before submitting it) ) and print out your headache report as well. 

Bring these two documents with you to your medical appointment.  Failure to do so may require you to reschedule your visit.

To access the headache questionnaire you will need:

1. a log in username and password, provided by Southcoast.

2. a six digit patient number provided by Southcoast.

These three items should have been provided you at the time you registered for your medical appointment.  If you do not have any or all of these please call Southcoast neurology at 508-993-3555 to obtain them.

When you click on the headache questionnaire link below an "Authentication Required" dialog box will appear. Enter the username and password provided you.  Click 'okay'.  See diagram 1 below.

diagram 1

The headache questionnaire will load in your Internet browser.  

Video.  Click on the video link to watch a short video providing information on how to complete the questionnaire and the types of headaches you will be queried about.  See diagram 2 below.

diagram 2

Return to the questionnaire and enter patient number, middle initial and date of birth (dob).  Remember to use the dob format shown on the questionnaire.

Answer the questions in the questionnaire. 

diagram 3

Before clicking on 'Submit Questionnaire' button print out the questionnaire by going to the tool bar on the top of the browser window, selecting 'file' and clicking on 'print'.  It is important that you print the questionnaire before submitting it in order to have a 'hard' copy to bring with you to your medical appointment.  See diagram 4 below.

diagram 4

In approximately 15 seconds after submitting the questionnaire your headache analysis report will appear in your browser.  Print a copy of this report and bring it with you to your medical appointment.