| 1.
Do you have any history of high blood pressure? |
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| 2.
Do you have a history of low blood pressure? |
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| 3.
Do you suffer from varicose veins? |
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| 4.
Do you suffer from leg ulcers or bruising? |
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| 5.
Have you any history of headaches? |
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| 6.
Have you suffered from phlebitis or thrombosis? |
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| 7.
Have you had a stroke or haemorrhage? |
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| 8.
Have you suffered from epilepsy? |
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| 9.
Do you have sinusitis or catarrh? |
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| 10.
Do you suffer from tonsillitis or sore throats? |
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| 11.
Do you or your family members have hayfever? |
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| 12.
Do you have any domestic pets ? |
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| 13.
Do you suffer from ear infections etc? |
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| 14.
Do you have any cardiac history? |
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| 15.
Have you suffered from bronchitis? |
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| 16.
Have you had any other lung problems/asthma etc? |
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| 17.
Do you have stomach acidity problems? |
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| 18.
Do you have pain relieved by eating/drinking? |
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| 19.
Do you have any pain relieved by fasting? |
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| 20.
Does your stomach bloat/rumble? |
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| 21.
Do you suffer from 'wind' going up or down? |
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| 22.
Have you any history of gastric illness? |
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| 23.
'Bugs'/salmonella/giardia/campylobacter? |
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| 24.
Does your bowel function run on a 24 hr basis? |
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| 25.
Do you have a loose bowel? |
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| 26.
Do you constipate easily? |
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| 27.
Do you have blood/mucus in stools? |
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| 28.
Do you have any unexplained weight loss or gain? |
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| 29.
Do you suffer from anal itching? |
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| 30.
Have you any known history of candida? |
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| 31.
Do you have any known food sensitivities? |
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| 32.
Have you a history of specific bowel disease eg colitis? |
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| 33.
Do you suffer any known liver disorders? |
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| 34.
Do you suffer from gall bladder disease? |
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| 35.
Have you any history of raised cholesterol? |
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| 36.
Do you have any pancreatic/diabetic history? |
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| 37.
Do you suffer from mouth ulcers? |
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| 38.
Do you have any history of kidney dysfunction? |
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| 39.
Do you retain fluid? |
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| 40.
Do you suffer from cystitis? |
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| 41.
Do you suffer from excessive urination? |
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| 42.
Do you have blood in your urine? |
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| 43.
Do you have any history of prostate problems? |
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| 44.
Do you have any problems emptying your bladder? |
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| 45.
Do you have any history of psoriasis or excema? |
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| 46.
Do you suffer acne, dermatitis etc? |
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| 47.
Do you have any history of auto immune disease? |
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| 48.
Do you have any known hormonal problems? |
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| 49.
Do you suffer easily from fatigue? |
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| 50.
Do you have a history of viral illness? |
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| 51.
Do your glands ache or swell? |
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| 52.
Do your muscles ache? |
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| 53.
Do you respond to changes in the seasons? |
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| 54.
Do you respond to changes in air pressure? |
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| 55.
Do you have any mercury fillings in your teeth? |
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| 56.
Do you have any implants, metal or otherwise? |
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| 57.
Do you have any root canal fillings? |
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| 58.
Have your wisdom teeth been removed? |
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| 59.
Have you any history of gum disease/lycomplanus? |
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| 60.
Do you have a history of anaemia? |
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| 61.
Do you suffer from any joint problem? |
|
| 62. Do you
have any known diagnosis for arthritis? |
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| 63.
Do you have any history of physical injury? |
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| 64.
Do you have any history of mental or emotional trauma? |
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| 65.
Does your lifestyle or work environment cause you stress? |
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| 66.
Do you have a good level of self esteem? |
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| 67.
Are you confident in what you do? |
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| 68.
Do you see yourself as an enthusiast? |
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| 69.
Do you see yourself as struggling to cope? |
|
| Just
for Women |
|
| 70.
Do you suffer painful breasts? |
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| 71.
Do you have a regular menstrual cycle? |
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| 72.
Do you suffer from prolonged periods? |
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| 73.
Do you suffer from period pains? |
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| 74.
Do you have fibroids? |
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| 75.
Do you have ovarian cysts? |
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| 76.
Do you suffer from tiredness/PMT etc? |
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