 The SPADE symptoms sleep, pain, anxiety, depression, and energyfatigue are the most common yet undertreated symptoms in clinical practice. Using the PROMIS Patient-Reported Outcome Measurement Information System Profile Scales as a measure of SPADE symptoms, this study will determine the effectiveness of providing patient symptom scores to clinicians, identify barriers and facilitators to the clinical use of such scores, and evaluate the psychometric properties of the PROMIS Profile Scales in a primary care population. 