SLE Symptom Checklist Form
Please review the following symptoms and indicate which you have experienced recently. This checklist is for informational purposes only.
Fatigue or unusual tiredness
Yes
Joint pain or swelling
Yes
Skin rash (including butterfly rash on face)
Yes
Mouth or nose ulcers
Yes
Fever (not explained by another cause)
Yes
Hair loss or thinning
Yes
Chest pain or shortness of breath
Yes
Sensitivity to sunlight (photosensitivity)
Yes
Headaches or confusion
Yes
Swelling in legs, ankles, or around eyes
Yes
Submit Checklist
Should be Empty: