PATIENT SYMPTOM SURVEY - Venture Chiropractic

stroke or circulatory disorder? high blood pressure? cancer, Hodgkins disease, lymphoma or tumors? Indicate type anemia, leukemia or other blood disorder? Indicate type diabetes? Your age at diagnosis? Check if insulin treated asthma, COPD, emphysema or other lung disease? Indicate /type ulcers, stomach, hepatitis or other liver disorder? ................
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