Please answer the following questions about your medical status and history.
REVIEW OF SYSTEMS: Please click to select all conditions that you have.
PLEASE PROVIDE EXPLANATION
High Blood Pressure
Chronic fever, unexpected weight loss/gain, fatigue
Skin (e.g., rashes, excessive dryness, rosacea, skin cancer)
Ear/nose/throat (e.g., hearing loss, sinus problems, sore throat, chronic cough)
Respiratory (e.g., asthma, emphysema, COPD, shortness of breath)
Cardiovascular (e.g., heart disease, chest pain, irregular heart beat)
Gastrointestinal (e.g., heart burn, ulcer, abdominal pain, diarrhea, vomiting)
Urinary (e.g., kidney/bladder conditions, pain or discomfort, blood in urine)
Musculoskeletal (e.g., arthritis, muscle aches, joint pain, swollen joints)
Neurologic (e.g., stroke, numbness, awakeness, headaches, paralysis)
Endocrine (diabetes, thyroid)
Psychiatric (e.g., depression, anxiety, panic attacks)
Autoimmune (e.g., lupus, rheumatoid arthritis, HIV/AIDS, hepatitis)