1058 lines
33 KiB
JSON
1058 lines
33 KiB
JSON
[
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{
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"label": "How would you describe your sex drive over the past year?",
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"key": "sex_drive",
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"type": "exact_match"
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},
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{
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"label": "Which of the following issues do you identify with?",
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"key": "maintaining_eriction",
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"type": "exact_match"
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},
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{
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"label": "Which of the following do you identify with?",
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"key": "ejaculation_issue",
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"type": "exact_match"
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},
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{
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"label": "How would you describe your activity levels?",
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"key": "activity_levels",
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"type": "exact_match"
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},
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{
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"label": "Do you experience constipation and gas regularly?",
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"key": "gas_constipation",
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"type": "exact_match"
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},
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{
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"label": "Do you have an existing doctor's prescription for your concerns?",
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"key": "existing_doctor",
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"type": "exact_match"
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},
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{
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"label": "Do you have a family history of growth hormone deficiency or related disorders?",
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"key": "family_history_hgh",
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"type": "exact_match"
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},
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{
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"label": "Have you experienced any major head injuries or surgeries involving the brain or pituitary gland?",
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"key": "head_injury",
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"type": "exact_match"
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},
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{
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"label": "Do you experience fatigue or lack of energy despite adequate rest?",
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"key": "fatigue",
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"type": "exact_match"
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},
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{
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"label": "Have you noticed a decrease in muscle mass or strength over the past year?",
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"key": "decrease_muscle",
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"type": "exact_match"
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},
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{
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"label": "Do you have difficulty losing weight, particularly around the abdomen?",
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"key": "weight_loss_dificulty",
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"type": "exact_match"
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},
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{
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"label": "Do you have reduced bone density or have you been diagnosed with osteoporosis?",
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"key": "reduce_bone_density",
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"type": "exact_match"
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},
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{
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"label": "Do you experience depression, anxiety, or other mood disturbances?",
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"key": "mood_disturbance",
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"type": "exact_match"
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},
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{
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"label": "Do you have difficulty concentrating or suffer from memory problems?",
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"key": "concentrating_problem",
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"type": "exact_match"
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},
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{
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"label": "Do you experience poor sleep quality or insomnia?",
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"key": "insomnia",
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"type": "exact_match"
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},
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{
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"label": "Do you have a reduced interest in sex or experience sexual dysfunction?",
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"key": "sex_dysfunction",
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"type": "exact_match"
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},
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{
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"label": "Do you smoke or use tobacco products?",
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"key": "tobacco_products",
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"type": "exact_match"
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},
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{
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"label": "Do you use any recreational drugs?",
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"key": "recreational_drugs",
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"type": "exact_match"
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},
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{
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"label": "Have you had any recent blood tests to measure your hormone levels, including growth hormone?",
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"key": "recent_blood_test",
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"type": "exact_match"
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},
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{
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"label": "Have you consulted a healthcare professional about your symptoms?",
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"key": "consultation_healthcare",
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"type": "exact_match"
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},
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{
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"label": "Are you currently taking any medication or supplements?",
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"key": "medication_or_suppliment",
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"type": "exact_match"
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},
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{
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"label": "Parkinson\u2019s Disease",
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"key": "parkinsons_disease",
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"type": "exact_match"
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},
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{
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"label": "Fibromyalgia",
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"key": "fibromyalgia",
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"type": "exact_match"
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},
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{
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"label": "Neck Surgery",
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"key": "neck_surgery",
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"type": "exact_match"
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},
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{
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"label": "Back Surgery",
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"key": "back_surgery",
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"type": "exact_match"
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},
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{
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"label": "Aneurysm Surgery",
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"key": "aneurysm_surgery",
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"type": "exact_match"
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},
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{
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"label": "Abdominal Surgery",
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"key": "Abdominal_Surgery",
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"type": "exact_match"
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},
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{
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"label": "Bowel Surgery",
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"key": "Bowel_Surgery",
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"type": "exact_match"
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},
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{
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"label": "Bypass in the legs",
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"key": "Bypass_in_the_legs",
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"type": "exact_match"
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},
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{
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"label": "Gallbladder Surgery",
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"key": "gallbladder_surgery",
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"type": "exact_match"
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},
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{
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"label": "Gastric bypass surgery",
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"key": "gastric_bypass_surgery",
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"type": "exact_match"
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},
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{
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"label": "Gynecologic surgery",
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"key": "gynecologic_surgery",
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"type": "exact_match"
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},
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{
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"label": "Intrathecal Pump",
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"key": "Intrathecal_pump",
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"type": "exact_match"
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},
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{
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"label": "Pacemaker Surgery",
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"key": "pacemaker_surgery",
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"type": "exact_match"
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},
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{
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"label": "Stimulator",
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"key": "stimulator",
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"type": "exact_match"
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},
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{
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"label": "Use caffeine",
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"key": "use_caffeine",
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"type": "exact_match"
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},
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{
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"label": "Dementia",
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"key": "dementia",
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"type": "exact_match"
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},
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{
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"label": "Epilepsy",
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"key": "epilepsy",
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"type": "exact_match"
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},
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{
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"label": "Migraine Headaches",
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"key": "migraine_headaches",
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"type": "exact_match"
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},
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{
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"label": "Polyneuropathy",
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"key": "polyneuropathy",
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"type": "exact_match"
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},
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{
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"label": "Tremor",
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"key": "tremor",
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"type": "exact_match"
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},
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{
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"label": "Poor memory",
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"key": "poor_memory",
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"type": "exact_match"
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},
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{
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"label": "Difficulty finding words",
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"key": "difficulty_finding_words",
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"type": "exact_match"
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},
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{
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"label": "Frequent sore throat",
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"key": "frequent_sore_throat",
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"type": "exact_match"
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},
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{
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"label": "Hoarseness",
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"key": "hoarseness",
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"type": "exact_match"
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},
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{
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"label": "Discharge from nose",
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"key": "discharge_from_nose",
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"type": "exact_match"
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},
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{
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"label": "Repeated sinus infections",
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"key": "repeated_sinus_infections",
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"type": "exact_match"
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},
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{
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"label": "Palpitations",
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"key": "palpitations",
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"type": "exact_match"
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},
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{
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"label": "Irregular heart beat",
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"key": "irregular_heart_beat",
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"type": "exact_match"
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},
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{
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"label": "Cold hands",
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"key": "cold_hands",
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"type": "exact_match"
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},
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{
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"label": "Cold feet",
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"key": "cold_feet",
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"type": "exact_match"
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},
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{
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"label": "Chronic cough",
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"key": "chronic_cough",
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"type": "exact_match"
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},
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{
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"label": "Muscle loss",
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"key": "muscle_loss",
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"type": "exact_match"
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},
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{
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"label": "Excessive thirst",
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"key": "excessive_thirst",
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"type": "exact_match"
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},
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{
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"label": "Farsighted",
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"key": "farsighted",
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"type": "exact_match"
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},
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{
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"label": "Nearsighted",
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"key": "nearsighted",
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"type": "exact_match"
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},
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{
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"label": "Changes in hair",
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"key": "changes_in_hair",
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"type": "exact_match"
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},
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{
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"label": "Changes in nails",
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"key": "changes_in_nails",
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"type": "exact_match"
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},
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{
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"label": "Changes in skin color",
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"key": "changes_in_skin_color",
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"type": "exact_match"
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},
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{
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"label": "Dry skin",
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"key": "dry_skin",
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"type": "exact_match"
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},
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{
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"label": "Extreme and insatiable hunger",
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"key": "instaiable_hunger",
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"type": "exact_match"
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},
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{
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"label": "genital pain",
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"key": "genital_pain",
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"type": "exact_match"
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},
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{
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"label": "The sensation of pain and\/or burning",
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"key": "sensation_of_pain_burning",
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"type": "exact_match"
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},
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{
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"label": "Urinary incontinence problem?",
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"key": "urinary_incontinence_problem",
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"type": "exact_match"
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},
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{
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"label": "Genital Sore?",
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"key": "genital_sore",
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"type": "exact_match"
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},
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{
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"label": "Are you Sexual active ?",
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"key": "sexual_active",
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"type": "exact_match"
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},
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{
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"label": "Lumps under the skin?",
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"key": "lumps_under_skin1",
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"type": "exact_match"
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},
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{
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"label": "Yellowing of eyes or skin (jaundice)?",
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"key": "jaundice",
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"type": "exact_match"
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},
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{
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"label": "Serious cough that brings up a lot of mucus or phlegm?",
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"key": "phlegm",
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"type": "exact_match"
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},
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{
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"label": "Problems with balance?",
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"key": "balance_problem",
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"type": "exact_match"
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},
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{
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"label": "Are you having pain now",
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"key": "pain_now",
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"type": "exact_match"
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},
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{
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"label": "Does anyone from Home Health or Hospice visit you at home?",
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"key": "hospice_visit_at_home",
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"type": "exact_match"
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},
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{
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"label": "Have you been able to continue most of your normal activities",
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"key": "normal_activities",
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"type": "exact_match"
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},
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{
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"label": "Unexplained weight loss\/Gain",
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"key": "unexplained_weight_loss_gain",
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"type": "exact_match"
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},
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{
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"label": "Has the patient ever had a breathing\/lung function test?",
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"key": "has_the_patient_ever_had_a_breathing_lung_function_test",
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"type": "exact_match"
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},
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{
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"label": "Stress test or treadmill test:",
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"key": "stress_test_or_treadmill_test",
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"type": "exact_match"
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},
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{
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"label": "Cardiac catheterization or angiogram:",
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"key": "cardiac_catheterization_or_angiogram",
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"type": "exact_match"
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},
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{
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"label": "Angioplasty or stent",
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"key": "angioplasty_or_stent",
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"type": "exact_match"
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},
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{
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"label": "Heart surgery If so, what kind?",
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"key": "heart_surgery_If_so_what_kind",
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"type": "exact_match"
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},
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{
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"label": "Do you follow a special meal plan or diet (such as Atkins\u00ae, Weight Watchers\u00ae, vegetarian, low fat, or diabetic)?",
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"key": "special_meal_plan_or_diet",
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"type": "exact_match"
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},
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{
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"label": "Do you exercise regularly?",
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"key": "do_you_exercise_regularly",
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"type": "exact_match"
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},
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{
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"label": "Over the last week, how itchy, sore, painful or stinging has your skin been?",
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"key": "how_itchy_skin",
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"type": "exact_match"
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},
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{
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"label": "Over the last week, how embarrassed or self conscious have you been because of your skin?",
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"key": "self_conscious_of_skin",
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"type": "exact_match"
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},
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{
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"label": "Over the last week, how much has your skin affected any social or leisure activities?",
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"key": "leisure_activity_affect_on_skin",
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"type": "exact_match"
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},
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{
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"label": "Over the last week, has your skin prevented you from working or studying?",
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"key": "prevent_from_study_skin",
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"type": "exact_match"
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},
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{
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"label": "Over the last week, how much has your skin created problems with your partner or any of your close friends or relatives?",
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"key": "skin_problem_with_partner",
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"type": "exact_match"
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},
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{
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"label": "Over the last week, how much has your skin caused any sexual difficulties?",
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"key": "sexual_difficulty_with_skin",
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"type": "exact_match"
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},
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{
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"label": "Over the last week, how much of a problem has the treatment for your skin been, for example by making your home messy, or by taking up time?",
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"key": "treatment_for_skin",
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"type": "exact_match"
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},
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{
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"label": "Are you pregnant or expecting to be?",
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"key": "medical_evaluation-less_then_a_year_ago",
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"type": "exact_match"
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},
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{
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"label": "Are you here to be evaluated for weight loss?",
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"key": "evaluate_weight_loss-yes",
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"type": "exact_match"
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},
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{
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"label": "Have you ever attempted to lose weight in a weight management program? Examples may include caloric restriction through diet, exercise, or behavior modification.",
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"key": "evaluate_weight_loss",
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"type": "exact_match"
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},
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{
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"label": "Have you ever attempted to lose weight in a weight management program?",
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"key": "evaluate_weight_loss",
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"type": "exact_match"
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},
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{
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"label": "Are you willing to reduce your caloric intake alongside medication?",
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"key": "caloric_intake",
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"type": "exact_match"
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},
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|
{
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|
"label": "Are you willing to increase your physical activity alongside medication?",
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"key": "physical_activity",
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|
"type": "exact_match"
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},
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{
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|
"label": "When was the last time you had an in person medical evaluation?",
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|
"key": "medical_evaluation-less_then_a_year_ago",
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|
"type": "exact_match"
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|
},
|
|
{
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|
"label": "Have you had any lab tests completed within the last 12 months that you would like to share with your doctor?",
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"key": "lab_tests_completed",
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|
"type": "exact_match"
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},
|
|
{
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|
"label": "Do you have any of the following?",
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"key": "comorbidities-high_cholesterol",
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|
"type": "exact_match"
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|
},
|
|
{
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|
"label": "Does anyone in your family have a history of...",
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|
"key": "chronic_pancreatitis",
|
|
"type": "exact_match"
|
|
},
|
|
{
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|
"label": "Do you have any of the following?",
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"key": "chronic_pancreatitis",
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|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any of the following?",
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|
"key": "kindney_history",
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|
"type": "exact_match"
|
|
},
|
|
{
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|
"label": "Are you pregnant or expecting to be?",
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|
"key": "m_g_expecting",
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|
"type": "exact_match"
|
|
},
|
|
{
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|
"label": "What specific conditions or symptoms are you seeking treatment for with TB-500?",
|
|
"key": "m_g_cond_symptoms_tb_500",
|
|
"type": "exact_match"
|
|
},
|
|
{
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|
"label": "Have you previously used TB-500 or any other peptide therapies?",
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|
"key": "m_g_peptide_tehrapies",
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|
"type": "exact_match"
|
|
},
|
|
{
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|
"label": "Have you had any recent surgeries or medical treatments for this condition?",
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|
"key": "m_g_medical_treatments",
|
|
"type": "exact_match"
|
|
},
|
|
{
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|
"label": "Do you have any chronic health conditions?",
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|
"key": "m_g_chronic_health_cond",
|
|
"type": "exact_match"
|
|
},
|
|
{
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|
"label": "Do you have any known allergies, particularly to medications or peptides?",
|
|
"key": "m_g_known_allergies",
|
|
"type": "exact_match"
|
|
},
|
|
{
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|
"label": "Are you currently taking any other medications or supplements?",
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"key": "m_g_other_medications",
|
|
"type": "exact_match"
|
|
},
|
|
{
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|
"label": "What is your current level of physical activity?",
|
|
"key": "m_g_physical_activity",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "When was the last time you had an in-person medical evaluation?",
|
|
"key": "m_g_in_person_med_evealuation",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you had any lab tests completed within the last 12 months that you would like to share with your doctor?",
|
|
"key": "m_g_tests_completed",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Upload your recent lab results (cholesterol, TSH, Ha1c, Creatinine):",
|
|
"key": null,
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Does anyone in your family have a history of gastrointestinal or metabolic conditions?",
|
|
"key": "m_g_gastrointestinal_or_metabolic_conditions",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Does anyone in your family have a history of thyroid issues or diabetes?",
|
|
"key": "m_g_thyroid_issues_or_diabetes",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you previously used PT-141 (Bremelanotide) injections?",
|
|
"key": "s_w_bremelanotide_injections",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "What is your primary concern related to sexual wellness?",
|
|
"key": "s_w_primary_concern",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "How long have you been experiencing issues with sexual wellness?",
|
|
"key": "s_w_experiencing_issues",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Are you currently taking any medications for sexual wellness?",
|
|
"key": "s_w_medications_current",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any known allergies to medications?",
|
|
"key": "s_w_allergies_medications",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you ever been diagnosed with any of the following conditions?",
|
|
"key": "s_w_diagnosed_conditions",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Are you currently under the care of a healthcare provider for any medical conditions?",
|
|
"key": "s_w_medical_conditions",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you had any recent changes in your health status?",
|
|
"key": "s_w_recent_changes",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you smoke or use tobacco products?",
|
|
"key": "s_w_tobaco_products",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you consume alcohol?",
|
|
"key": "s_w_tobaco_alchole",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any concerns about your heart health or blood pressure?",
|
|
"key": "s_w_bp_hh",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Are you currently experiencing any psychological stressors or mental health concerns that may affect your sexual wellness?",
|
|
"key": "s_w_mental_health",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Are you currently taking any medications that might interfere with sexual function (e.g., antidepressants, blood pressure medications)?",
|
|
"key": "s_w_sexual_function",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you ever been diagnosed with any hormonal imbalances?",
|
|
"key": "s_w_hormonal_imblance",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you previously experienced any side effects from sexual wellness medications?",
|
|
"key": "s_w_sexual_wellness",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have a history of any psychiatric conditions (e.g., depression, anxiety)?",
|
|
"key": "s_w_psychiratric_cond",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Are you currently under treatment for any hormonal conditions (e.g., testosterone replacement therapy)?",
|
|
"key": "s_w_under_treatment",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any concerns about potential side effects of PT-141 injections?",
|
|
"key": "s_w_pt-141_inj",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "How often do you experience sexual difficulties?",
|
|
"key": "s_w_sexual_difficulties",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you ever consulted a healthcare provider or therapist for sexual wellness issues?",
|
|
"key": "s_w_sexual_wellness_issues",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any upcoming surgeries or medical procedures planned?",
|
|
"key": "s_w_procedures_plan",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Are you currently taking any supplements or over-the-counter medications for sexual health?",
|
|
"key": "s_w_sexual_health",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you noticed any changes in your sexual desire or function recently?",
|
|
"key": "s_w_sexual_desire",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any chronic pain conditions that might affect your sexual wellness?",
|
|
"key": "s_w_chronic_pain",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "How would you rate your overall health?",
|
|
"key": "s_w_overall_health",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any concerns about confidentiality or privacy regarding your sexual wellness treatment?",
|
|
"key": "s_w_condentiality_sexeual_wellness",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Are you open to lifestyle changes (e.g., diet, exercise) to improve your sexual wellness?",
|
|
"key": "s_w_lifestyle_changes",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you currently experience any gastrointestinal issues (e.g., nausea, vomiting) that might affect medication absorption?",
|
|
"key": "s_w_gastrointestial_issues",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Would you be willing to undergo periodic medical evaluations to monitor your response to PT-141 treatment?",
|
|
"key": "s_w_willing_to_undergo",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "What are your primary concerns related to aging?",
|
|
"key": "ag_aging_related",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "How long have you been experiencing these aging concerns?",
|
|
"key": "ag_how_long_aging_exp",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you previously used peptides for anti-aging purposes?",
|
|
"key": "ag_aging_peptide",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Are you currently taking any medications or supplements for anti-aging?",
|
|
"key": "ag_current_medications",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any known allergies to medications or peptides?",
|
|
"key": "ag_known_allergies",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you been diagnosed with any of the following conditions?",
|
|
"key": "ag_diagnosed_condition",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Are you currently under the care of a healthcare provider for any chronic conditions?",
|
|
"key": "s_w_medical_conditions",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any family history of age-related diseases (e.g., Alzheimer's, osteoporosis)?",
|
|
"key": "ag_related_history",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you smoke or use tobacco products?",
|
|
"key": "s_w_tobaco_products",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you consume alcohol?",
|
|
"key": "s_w_tobaco_alchole",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you had any recent changes in your health status or new diagnoses?",
|
|
"key": "ag_heath_status",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have a regular exercise routine?",
|
|
"key": "ag_nutrational_plan",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you follow a specific diet or nutritional plan?",
|
|
"key": "ag_anti_aging_treatment_in_past",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you experienced any adverse reactions to anti-aging treatments in the past?",
|
|
"key": "ag_peptide_using-improve_skin_appearance",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "How would you rate your overall energy levels?",
|
|
"key": "ag_overall_energy_levels",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any concerns about potential side effects of CJC-1295, Ipamorelin, or GHK-Cu?",
|
|
"key": "ag_cjc_1295",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Are you currently experiencing any symptoms of hormone imbalance (e.g., low libido, fatigue, mood swings)?",
|
|
"key": "ag_exp_fatigue",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any history of cancer or undergoing cancer treatment?",
|
|
"key": "ag_undergoing_cancer",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you undergone any cosmetic procedures or treatments in the past year?",
|
|
"key": "ag_cosmatic_procdeures",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Are you currently taking any medications that might interfere with peptide therapy?",
|
|
"key": "ag_peptide_therapy",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you ever been diagnosed with any autoimmune diseases?",
|
|
"key": "ag_autoimmune_diseases",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any chronic pain conditions that might affect your treatment?",
|
|
"key": "ag_chronic_pain",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "How would you describe your sleep quality?",
|
|
"key": "ag_sleep_quality",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Would you be willing to undergo periodic medical evaluations to monitor your response to peptide treatment?",
|
|
"key": "ag_response_peptide_treatment",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any skin conditions or sensitivities that might affect the use of GHK-Cu?",
|
|
"key": "ag_ghkcu",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Are you interested in combining peptide therapy with other anti-aging treatments or lifestyle changes?",
|
|
"key": "ag_combining_peptide_therapy",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any concerns about confidentiality or privacy regarding your anti-aging treatment?",
|
|
"key": "ag_confidentiality",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "How often do you experience stress or high-pressure situations?",
|
|
"key": "ag_stress",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Are you open to making lifestyle changes (e.g., diet, exercise, stress management) to enhance the effects of peptide therapy?",
|
|
"key": "ag_lifestyle_changes",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "What are your primary concerns regarding DNA damage or cellular repair?",
|
|
"key": "dna_damage_cellular_repair",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "How long have you been aware of or concerned about DNA damage?",
|
|
"key": "dna_how_long_dammage",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you previously used any peptides or treatments specifically for DNA repair?",
|
|
"key": "dna_peptide_treatment",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any known allergies to medications or peptides?",
|
|
"key": "ag_current_medications",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you been diagnosed with any conditions related to cellular damage or DNA repair (e.g., cancer, genetic disorders)?",
|
|
"key": "dna_disorder",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Are you currently taking any medications or supplements that support DNA repair or cellular health?",
|
|
"key": "ag_diagnosed_condition",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any family history of genetic disorders or diseases related to DNA damage?",
|
|
"key": "dna_genetic_disorder",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "What are your goals for using CJC-1295 for DNA repair?",
|
|
"key": "dna_cjc_1295",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have a regular routine for exercise and physical activity?",
|
|
"key": "dna_regular_activity",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "How would you rate your current overall health?",
|
|
"key": "dna_overall_health",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you follow any specific dietary or nutritional plans to support cellular health?",
|
|
"key": "dna_nutritional_plans",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you had any recent changes in your health status, such as new diagnoses or treatments?",
|
|
"key": "dna_diagnoses",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any concerns about potential side effects of CJC-1295?",
|
|
"key": "dna_cjc_1295_sideeffects",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Would you be willing to undergo periodic medical evaluations to monitor your response to CJC-1295 therapy?",
|
|
"key": "dna_monitor_cjc_1295_response",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Are you open to incorporating additional lifestyle changes (e.g., diet, stress management) to enhance the effectiveness of CJC-1295 for DNA repair?",
|
|
"key": "dna_enhance_cjc_1295_effectiveness",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "**Have you ever experienced any adverse reactions to peptide treatments in the past?",
|
|
"key": "dna_adverse_reaction_peptide_therapy",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you currently experience any symptoms of hormone imbalance (e.g., fatigue, low libido, mood swings)?",
|
|
"key": "dna_harmone_imblance",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you ever been diagnosed with any autoimmune diseases?",
|
|
"key": "dna_autoimmune_diseases",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any chronic pain conditions or inflammatory disorders?",
|
|
"key": "dna_inflammatory_disorders",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have a history of cardiovascular disease or uncontrolled high blood pressure?",
|
|
"key": "dna_cardiovascular_disease",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "What are your primary concerns regarding hair loss?",
|
|
"key": null,
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "How long have you been experiencing hair loss?",
|
|
"key": "hg_hair_loss-less_than_6_mnths",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you tried any treatments for hair loss before?",
|
|
"key": "hg_treatment_hair_loss",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "If yes, what treatments have you tried?",
|
|
"key": "hg_tried_treatment_yes",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any family history of hair loss or baldness?",
|
|
"key": "hg_family_history_hair_loss",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Are you currently taking any medications or supplements?",
|
|
"key": "hg_current_medications",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any known allergies to medications or peptides?",
|
|
"key": "hg_current_medication",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any chronic health conditions?",
|
|
"key": "hg_chronic_conditions",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you been diagnosed with any hormonal imbalances (e.g., thyroid issues, PCOS)?",
|
|
"key": "hg_hormonal_imblance",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you experience any scalp issues (e.g., dandruff, psoriasis, eczema)?",
|
|
"key": "hg_scalp_issues",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Have you undergone any recent medical treatments or surgeries?",
|
|
"key": "hg_undergoing_treatments",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you smoke or use tobacco products?",
|
|
"key": "hg_tobbaco_products",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you consume alcohol?",
|
|
"key": "hg_consume_alchol",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "How would you describe your diet?",
|
|
"key": "hg_diet_describe",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have a regular exercise routine?",
|
|
"key": "hg_exersice_rutine",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "How would you rate your stress levels?",
|
|
"key": "hg_stress_levels",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Do you have any concerns about potential side effects of peptide treatments for hair growth?",
|
|
"key": "hg_peptide_side_effects",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Would you be willing to undergo periodic medical evaluations to monitor your response to treatment?",
|
|
"key": "hg_evaluation_response",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "Are you open to combining peptide therapy with other hair growth treatments or lifestyle changes?",
|
|
"key": "hg_hair_growth_treatment",
|
|
"type": "exact_match"
|
|
},
|
|
{
|
|
"label": "What are your goals for using peptide therapy for hair growth?",
|
|
"key": "hg_using_peptide_therapy",
|
|
"type": "exact_match"
|
|
}
|
|
]
|