SYMPTOMS REGISTRATION

1. Do you experience stiffness of fingers and toes upon waking?

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2. Do you experience weakness in your whole body?

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3. Have you noticed any swelling in your hands, feet or ankles?

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4. Do you suffer from anaemia?

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6. Have you noticed any recent weight loss?

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7. Do you experience any IBS like symptoms such as: bloating, reflux, flatulence?

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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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