Questionnaire Index

Filling in specific questionnaire page(s)

Click the link below for the the first page that you would like to redo.  Be sure to choose the correct page, male or female (left or right side).

• Note that you will not see any of your previous responses.
• Remember to click "Save Answers and Continue" at the end of each page.
• When finished, close that browser window to return here.
• Repeat this procedure for each page or set of pages you need to redo.

Viewing a questionnaire page

Click the page link below to open it in a new browser window.  Note that you will not see any of your previous responses, but we do have them in our database.

MALE questionnaire   Page 1     Personal Background     Habits And Activities     Symptoms General     Symptoms Aging     Symptoms Food General     Symptoms Food Intake     Page 1(a)         Tropical Travel     Page 1(b)         Fatigue     Page 1(c)         Weight-Loss Diets     Page 1(d)         Eating Issues   Page 2     Symptoms Food Preferences     Symptoms Food Beverages     Symptoms Environmental     Symptoms Muscular     Symptoms Skeletal     Symptoms Nervous     Page 2(a)         Vegan Diet     Page 2(b)         Alcohol     Page 2(c)         Coffee And Tea     Page 2(d)         Soft Drinks     Page 2(e)         Tobacco Use     Page 2(f)         Hazardous Substances     Page 2(g)         Allergic And Adverse Reactions     Page 2(h)         Reaction To Cold Damp Weather     Page 2(i)         Muscular Symptoms     Page 2(j)         Morning Stiffness     Page 2(k)         Neck Back Problems     Page 2(l)         Joint Problems     Page 2(m)         Limb Problems     Page 2(n)         Unusual Skin Sensations     Page 2(o)         Twitching And Cramping     Page 2(p)         Neck Problems   Page 3     Symptoms Liver Gallbladder     Symptoms Gast-Int General     Symptoms Bowel Movements     Symptoms Mouth     Symptoms Eyes General     Symptoms Ears General     Page 3(a)         Gallbladder Problems     Page 3(b)         Liver Problems     Page 3(c)         Digestive Problems     Page 3(d)         Abdominal Problems     Page 3(e)         Bowel Problems     Page 3(f)         Parasites     Page 3(g)         Unusual Bowel Movements     Page 3(h)         Symptoms Missing Teeth     Page 3(i)         Symptoms Mouth Specific     Page 3(j)         Symptoms Eyes Specific     Page 3(k)         Symptoms Ears Specific   Page 4     Symptoms Nose     Symptoms Mind General     Symptoms Mind Emotional     Page 4(a)         Mental Conditions     Page 4(b)         Major Life Changes     Page 4(c)         Depression   Page 5     Symptoms Glandular     Symptoms Metabolic     Symptoms Urinary     Symptoms Reproductive     Page 5(a)         Diabetes     Page 5(b)         Symptoms Lymph Nodes     Page 5(c)         Symptoms Edema     Page 5(d)         Headaches     Page 5(e)         Weight Problems     Page 5(f)         Prostate Problems     Page 5(g)         Symptoms STDs   Page 6     Symptoms Respiratory     Symptoms Sleep     Symptoms Cardiovascular     Symptoms Immune System     Symptoms Skin General     Page 6(a)         Breathing Difficulty     Page 6(b)         Chest Discomfort     Page 6(c)         Sleep Problems     Page 6(d)         Heart Problems     Page 6(e)         Anemia     Page 6(f)         Symptoms Cancers         Additional Cancer Questions   Page 7     Symptoms Skin Conditions     Symptoms Hair     Symptoms Nails     Supplements And Medications     Page 7(a)         Symptoms Nipples     Page 7(b)         Symptoms Nail Abnormalities     Page 7(c)         Nutritional Supplements     Page 7(d)         Antacid Use     Page 7(e)         Prescription Antibiotic Use     Page 7(f)         Psychotropic Drug Use     Page 7(g)         Hormone Use     Page 7(h)         Laxative Use     Page 7(i)         Pain Medication     Page 7(j)         Anti-inflammatory Use     Page 7(k)         Recreational Drugs     Page 7(l)         Miscellaneous Medications     Page 7(m)         Natural Progesterone Use   Page 8     Medical Procedures     Common Lab Values     Family History     Childhood     Page 8(a)         Past Surgeries     Page 8(b)         Lab Values Cells         Lab Values Chemistries         Lab Values Hormones         Lab Values Nutrients         Lab Values Scans         Other Diagnostic Tests     Page 8(c)         Family History   Page 9     Contact Details     Height, Weight     Further Information, Comments

FEMALE questionnaire   Page 1     Personal Background     Habits And Activities     Symptoms General     Symptoms Aging     Symptoms Food General     Symptoms Food Intake     Page 1(a)         Tropical Travel     Page 1(b)         Fatigue     Page 1(c)         Weight-Loss Diets     Page 1(d)         Eating Issues   Page 2     Symptoms Food Preferences     Symptoms Food Beverages     Symptoms Environmental     Symptoms Muscular     Symptoms Skeletal     Symptoms Nervous     Page 2(a)         Vegan Diet     Page 2(b)         Alcohol     Page 2(c)         Coffee And Tea     Page 2(d)         Soft Drinks     Page 2(e)         Tobacco Use     Page 2(f)         Hazardous Substances     Page 2(g)         Allergic And Adverse Reactions     Page 2(h)         Reaction To Cold Damp Weather     Page 2(i)         Muscular Symptoms     Page 2(j)         Morning Stiffness     Page 2(k)         Neck Back Problems     Page 2(l)         Joint Problems     Page 2(m)         Limb Problems     Page 2(n)         Unusual Skin Sensations     Page 2(o)         Twitching And Cramping     Page 2(p)         Neck Problems   Page 3     Symptoms Liver Gallbladder     Symptoms Gast-Int General     Symptoms Bowel Movements     Symptoms Mouth     Symptoms Eyes General     Symptoms Ears General     Page 3(a)         Gallbladder Problems     Page 3(b)         Liver Problems     Page 3(c)         Digestive Problems     Page 3(d)         Abdominal Problems     Page 3(e)         Bowel Problems     Page 3(f)         Parasites     Page 3(g)         Unusual Bowel Movements     Page 3(h)         Symptoms Missing Teeth     Page 3(i)         Symptoms Mouth Specific     Page 3(j)         Symptoms Eyes Specific     Page 3(k)         Symptoms Ears Specific   Page 4     Symptoms Nose     Symptoms Mind General     Symptoms Mind Emotional     Page 4(a)         Mental Conditions     Page 4(b)         Major Life Changes     Page 4(c)         Depression   Page 5     Symptoms Glandular     Symptoms Metabolic     Symptoms Urinary     Symptoms Female     Symptoms Reproductive     Page 5(a)         Diabetes     Page 5(b)         Symptoms Lymph Nodes     Page 5(c)         Symptoms Edema     Page 5(d)         Headaches     Page 5(e)         Weight Problems     Page 5(f)         Pregnancy Experience     Page 5(g)         Past Pregnancies     Page 5(h)         Current Pregnancy     Page 5(i)         Unusual Vaginal Symptoms     Page 5(j)         Pre-Menopause     Page 5(k)         Post-Menopause     Page 5(l)         Symptoms STDs     Page 5(m)         Unusual Vaginal Discharge   Page 6     Symptoms Respiratory     Symptoms Sleep     Symptoms Cardiovascular     Symptoms Immune System     Page 6(a)         Breathing Difficulty     Page 6(b)         Chest Discomfort     Page 6(c)         Sleep Problems     Page 6(d)         Heart Problems     Page 6(e)         Anemia     Page 6(f)         Symptoms Cancers         Additional Cancer Questions   Page 7     Symptoms Skin General     Symptoms Skin Conditions     Symptoms Hair     Symptoms Nails     Page 7(a)         Symptoms Nipples     Page 7(b)         Symptoms Nail Abnormalities   Page 8     Supplements And Medications     Medical Procedures     Common Lab Values     Family History     Childhood     Page 8(a)         Nutritional Supplements     Page 8(b)         Antacid Use     Page 8(c)         Prescription Antibiotic Use     Page 8(d)         Psychotropic Drug Use     Page 8(e)         Hormone Use     Page 8(f)         Laxative Use     Page 8(g)         Pain Medication     Page 8(h)         Anti-inflammatory Use     Page 8(i)         Recreational Drugs     Page 8(j)         Miscellaneous Medications     Page 8(k)         Past Surgeries     Page 8(l)         Lab Values Cells         Lab Values Chemistries         Lab Values Hormones         Lab Values Nutrients         Lab Values Scans         Other Diagnostic Tests     Page 8(m)         Family History     Page 8(n)         Natural Progesterone Use   Page 9     Contact Details     Height, Weight     Further Information, Comments