Microsoft Word - Keays Medical Group
SYMPTOM SURVEY. Circle the symptom if you are currently experiencing it or it is a common occurrence. Underline the symptom if it is now not a problem, but was sometime in the past, (over 3 months ago). GENERAL. Low energy -fatigue . Weakness . Fever - Chills . Headaches . Lack of sleep . Reduced mental acuity . SKIN. Dry skin . Itching ... ................
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