| Symptom | Score |
| Headache | |
| None at all | 0 |
| A mild headache | 1 |
| Moderate headache | 2 |
| Severe headache, incapacitating | 3 |
| Gastrointestinal symptoms | |
| Good appetite | 0 |
| Poor appetite or nausea | 1 |
| Moderate nausea or vomiting | 2 |
| Severe nausea and vomiting, incapacitating | 3 |
| Fatigue and/or weakness | |
| Not tired or weak | 0 |
| Mild fatigue/weakness | 1 |
| Moderate fatigue/weakness | 2 |
| Severe fatigue/weakness, incapacitating | 3 |
| Dizziness/light-headedness | |
| No dizziness/light-headedness | 0 |
| Mild dizziness/light-headedness | 1 |
| Moderate dizziness/light-headedness | 2 |
| Severe dizziness/light-headedness, incapacitating | 3 |
| AMS clinical functional score | |
| Overall, if you had AMS symptoms, how did they affect your activities? | |
| Not at all | 0 |
| Symptoms present, but did not force any change in activity or itinerary | 1 |
| My symptoms forced me to stop the ascent or to go down on my own power | 2 |
| Had to be evacuated to a lower altitude | 3 |
| Total | |
