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Check all of the symptoms you have experienced in the past 6 months (required)
HeadachesNeck PainBack PainLeg or Hip PainArthritisShoulder/Arm PainCarpal Tunnel PainIrritabilityDizzinessProblems SleepingWeight TroubleLow Energy/FatigueTingling/Numbness in Arms or Legs

Other symptoms

Which of the above symptoms concerns you the most? (required)

Concerning that symptom, how long have you experienced it? (required)

Are any of the above selected symptoms the result of a recent auto accident? (required)