UPDATE FORM

  • What's your food like these days?

  • Symptom Questionnaire

  • Please use this scale to rate the frequency and severity of symptoms you have experienced over the past two weeks. If multiple choices are given, please specify what applies in the comment column.
    • 0 - Never have the symptom.
    • 1 - Occasionally have it and the effect is mild.
    • 2 - Occasionally have it and the effect is severe.
    • 3 - Frequently or Consistently have it and the effect is Mild
    • 4 - Frequently or Consistently have it and the effect is Severe
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