Table 1.

Questionnaire for verifying stroke-free status⁸

Medical history

Were you ever told by a physician that you had a stroke?

Were you ever told by a physician that you had a mini-stroke or transient ischemic attack?

Review of symptoms

Have you ever had sudden, painless weakness on one side of your body?

Have you ever had sudden numbness or a dead feeling on one side of your body?

Have you ever had sudden, painless loss of vision in one or both eyes?

Have you ever suddenly lost half of your vision?

Have you ever suddenly lost the ability to understand what people were saying?

Have you ever suddenly lost the ability to express yourself verbally or in writing?