THRIVE Index — Monthly Health Check-in | The Tick Center at MVM
The Tick Center @ Martha's Vineyard Medical THRIVE Index · Monthly Health Check-in
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Monthly Health Check-in

THRIVE Index

Tick-borne Health Resilience Index

Your name
Date of birth
Today's date
Condition
ⓘ

How to complete this form: For each question, select the number from 1 to 10 that best describes how you have felt over the past 30 days. A higher number is always better. Questions marked AGS or Lyme only will show or hide based on your condition. There are no right or wrong answers.

1
Physical
Pain, fatigue, and symptoms  ·  25% of THRIVE score
1
How would you rate your overall pain and body aches over the past 30 days?
1 = severe pain  ·  10 = no pain at all
Severe painNo pain
2
How severe has your fatigue been over the past 30 days?
1 = completely exhausted  ·  10 = full energy
ExhaustedFull energy
3
How much have your symptoms interfered with daily life over the past 30 days?
1 = severely interfered  ·  10 = no interference
Severe interferenceNo interference
AGS patients only
4
How many allergic reactions have you had in the past 30 days?
1 = multiple severe reactions  ·  10 = no reactions at all
Many reactionsNo reactions
2
Functional
Daily capacity, activity, and sleep  ·  25% of THRIVE score
5
How well have you been able to carry out your usual daily activities over the past 30 days?
1 = unable to manage  ·  10 = full capacity
UnableFull capacity
6
How would you describe your level of physical activity over the past 30 days?
1 = almost none  ·  10 = as active as I want to be
Almost noneFully active
7
How would you rate the quality of your sleep over the past 30 days?
1 = very poor  ·  10 = excellent
Very poorExcellent
8
How would you describe your overall energy levels over the past 30 days?
1 = no energy  ·  10 = high energy
No energyHigh energy
Lyme patients only
9
Do you experience worsening symptoms after physical or mental effort?
1 = always worsens significantly  ·  10 = no worsening at all
Always worsensNo worsening
3
Emotional
Mood, anxiety, and coping  ·  20% of THRIVE score
10
How would you describe your overall mood over the past 30 days?
1 = very low or depressed  ·  10 = excellent mood
Very lowExcellent
11
How much has anxiety or worry affected you over the past 30 days?
1 = severely anxious  ·  10 = calm and settled
Severely anxiousCalm
12
How well do you feel you are coping with your condition over the past 30 days?
1 = really struggling  ·  10 = coping very well
StrugglingCoping well
13
Overall, how would you rate your quality of life over the past 30 days?
1 = very poor  ·  10 = excellent
Very poorExcellent
Lyme patients only
14
How clear has your thinking and concentration been over the past 30 days?
1 = severe brain fog  ·  10 = completely clear
Severe fogClear
4
Nutritional
Diet, gut health, and food confidence  ·  20% of THRIVE score
15
How would you rate the overall quality of your diet over the past 30 days?
1 = very poor  ·  10 = excellent
Very poorExcellent
16
How has your digestive comfort been over the past 30 days?
1 = very uncomfortable  ·  10 = completely comfortable
UncomfortableComfortable
AGS patients only
17
How consistently have you avoided mammalian meat and alpha-gal products over the past 30 days?
1 = not at all consistent  ·  10 = completely consistent
Not consistentFully consistent
18
How confident do you feel navigating food choices safely in daily life?
1 = very anxious about food  ·  10 = fully confident
Very anxiousFully confident
5
Constitutional
Energy balance and integrative health  ·  10% of THRIVE score
19
How balanced and stable has your energy felt over the past 30 days?
1 = very erratic or depleted  ·  10 = steady and balanced
ErraticBalanced
20
How reactive have you been to environmental factors such as temperature, seasonal change, or chemical exposures?
1 = highly reactive  ·  10 = not reactive at all
Highly reactiveNot reactive
21
How well do you feel your integrative treatments are working over the past 30 days?
Select N/A if you are not currently receiving integrative treatment
Not workingWorking well
22
Overall, how well does your body feel in balance — physically, emotionally, and energetically?
1 = very out of balance  ·  10 = completely in balance
Out of balanceIn balance
Anything else?
Optional — share anything you'd like your provider to know this month

Your responses will be sent securely to The Tick Center team and reviewed at your next quarterly visit.

✓

Check-in submitted

Thank you. Your THRIVE Index responses have been sent to The Tick Center team and will be reviewed at your next quarterly visit.

If you have any urgent concerns, please call us at (508) 693-4400.