HMQ: Multiple Systemic Infectious Disease Syndrome (MSIDS) Questionnaire
This form has been validated in an article published in the International Journal of General Medicine; 

This is a questionnaire to determine the probability of your having Lyme Disease and other tick-borne disorders.

MSIDS is a symptom complex of Lyme disease and multiple associated tick borne coinfections that encompasses not only infections with Borrelia burgdorferi, the etiological agent of Lyme Disease, but also other
bacterial infections, viral infections, parasitic
infections, and fungal infections.”

1.You have more than one symptom; Fatigue, Joint & Muscle pain, Tingling, Numbness & burning sensations, Stiff neck, Headaches,  Light & Sound sensitivity, Dizziness, Sleep problems, Memory & Concentration problems, Chest pain & Palpitations, Psychiatric symptoms (depression, anxiety, etc.)
2. You have good days and bad days. A hallmark of Lyme disease is that the symptoms tend to come and go with good and bad days.
3. The pain changes and moves around the body Another classic trait of Lyme disease is the migratory nature of the pain.
4. If you're a woman, your symptoms worsen right around your cycle.
5. Your symptoms improve when you're taking medication (especially antibiotics) for other ailments.
6. Blood tests have confirmed this.

DISCLAIMER: The Lyme Action Network is not a medical organization and does not purport to provide medical advice. The
information herein is provided for general information purposes only. We do not make any warranties about the information contained herein, and will not be liable for any losses or damages in connection with the use of our informational.  The Horowitz Lyme-MSIDS Questionnaire is not intended to replace the advice of your own
physician or other medical professional. You should consult a medical professional in matters relating
to health, and individuals are solely responsible for their own health care decisions regarding the use of
this questionnaire. It is intended for informational purposes only and not for self-treatment or diagnosis.

If you scored 46 or more, you have a high probability of a tick-borne disorder and should see a health-care provider for further evaluation.
If you scored between 21 and 45, you possibly have a tick-borne disorder and should see a health-care provider for further evaluation.
If you scored under 21, you are not likely to have a tick-borne disorder.
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