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Self-Diagnostic Tests
In the past 1 month, have you experienced a feeling of numbness or tingling?
*
Yes
No
In the past 1 month, have you been bothered by Hot Flashes?
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Yes
No
In the past 1 month, have you felt wobbly in your legs at any time?
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Yes
No
In the past 1 month, have you found yourself unable to relax?
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Yes
No
In the past 1 month, have you found yourself fearing the worst happening?
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Yes
No
In the past 1 month, have you found heart pounding/racing?
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Yes
No
In the past 1 month, have you experienced a feeling of unsteadiness?
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Yes
No
In the past 1 month, have you been feeling terrified or afraid?
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Yes
No
In the past 1 month, have you been feeling nervous?
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Yes
No
In the past 1 month, have you experienced a feeling of choking?
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Yes
No
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