Anemia Symptoms Quiz

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. Print this page and answer each question below to the best of your ability. Then discuss your answers 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.

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
    

How to use this form:

• Print these questions
• Answer to the best of your ability
• Discuss your answers with your doctor

Last Updated: March 31, 2008