Dose the patient being treated have any of the following conditions?

• Under eight years old.

• Signs of infection (abdominal pain, nausea, vomiting, diarrhea, cuts that are inflamed or exuding pus, recent exposure to bacteria, other symptoms).

• Consuming three or more alcoholic drinks per day.

• Headache is from another health condition (secondary).

• Having any of the following symptoms and have never been diagnosed with a migraine: Nausea, headache on only one side of the head, visual changes such as seeing lines or changes in light before the onset of the headache, numbness or tingling before the onset of the headache, trouble speaking before the onset of the headache, worsened mood after the headache, depression after the headache, fatigue after the headache, and difficulty solving problems after the headache.

• Severe head pain.

• A headache that has persisted for more than ten days.

• Pregnancy.

• Fever over 103 degrees F.

• Allergies to pain reliever medications (ibuprofen, tylenol, aspirin).

• Using over the counter pain reliever medicines more than three days per week for headaches without improvement.


Yes

No



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