SYMPTOMS REGISTRATION

1. Have you noticed that your stools are bulky, pale or and/or greasy?

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2. Have you experienced any recent weight loss?

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3. When was your last blood test done?

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4. Have you had a antibodies test?

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5. Have you had a biopsy done?

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SYMPTOMS REGISTRATION
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Personal Health History

Any current health condition diagnosis?

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Any past health condition?

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Any past hospitalisations/surgeries?

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Have you ever taken any antibiotics?

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Have you ever taken birth control?

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Have you ever been on hormone replacement therapy?

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