Rate each of the following symptoms based upon your typical health profile for the past 14 days.
Point Scale:
0 - Never or almost never have the symptom
1 - Occasionally have it, effect is not severe
2 - Occasionally have it, effect is severe
3 - Frequently have it, effect is not severe
4 - Frequently have it, effect is severe
HEAD
EYES
EARS
NOSE
MOUTH/THROAT
SKIN
HEART
LUNGS
DIGESTIVE TRACT
JOINTS/MUSCLE
WEIGHT
ENERGY/ACTIVITY
MIND
EMOTIONS
OTHER