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Hormone Analysis

The Healthy Choice Menopause Assessment

Welcome to The Healthy Choice Menopause Symptom Assessment Survey! Simply rate the severity of your symptoms below and get your free, customized assessment…
 
A note on privacy: This survey is anonymous.
 
The record kept of your survey responses does not contain any identifying information about you unless a specific question in the survey has asked for this. If you have responded to a survey that used an identifying token to allow you to access the survey, you can rest assured that the identifying token is not kept with your responses. It is managed in a separate database, and will only be updated to indicate that you have (or haven’t) completed this survey. There is no way of matching identification tokens with survey responses in this survey.
 

Rate Your Symptoms

Below is a list of different symptoms related to the onset of menopause. All questions are required.
 
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1 Step 1
N/AMildModerateSevere
Hot Flashes / Night Sweats
Breast Tenderness
Cold Hands / Feet
Fatigue
Mood Swings
Menstrual Cramps
Irregular Periods
Bloating
Joint Pain
Insomnia / Sleep Disturbance
Weight Gain
Frequent Headaches
Loss of Sex Drive
Are You Stressed?
Weight Gain around the Abdomen
Surgical Menopause: Hysterectomy
Medical Menopause: fertility drugs, radiation, chemotherapy
Do you Smoke?
Do you drink alcohol?
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