Restless Leg Syndrome (RLS) Severity Scale

Overall, how would you rate the RLS discomfort in your legs or arms? *

Overall, how would you rate the need to move around because of your RLS symptoms? *

Overall, how much relief of your RLS arm or leg discomfort do you get from moving around? *

Overall, how severe is your sleep disturbance due to your RLS symptoms? *

How severe is your tiredness or sleepiness due to your RLS symptoms? *

Overall, how severe is your RLS as a whole? *

How often do you get RLS symptoms? *

When you have RLS symptoms, how severe are they on an average day? *

Overall, how severe is the impact of your RLS symptoms on your ability to carry out your daily affairs, for example carrying out a satisfactory family, home, social, school or work life? *

How severe is your mood disturbance from your RLS symptoms, for example angry, depressed, sad, anxious or irritable? *