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Now You Can Fill your
Health Questionnaire

We need this information to set up the correct mix of pulsed magnetic field that will be best for your condition.

After we set up the optimum mix of programs we will send it to you as an mp3 attachment by email.

In case you have already filled in the groups 1 to 8 and the stress test, leave it blank.

Define Best Individualized Approach

Please note that all fields followed by an asterisk must be filled in.
A Multiple pains
B Fatigue
C Family History of FMS
A Poor Sleep
B Morning stiffness
A Chest problems
B Abdomen problems
C Pelvic problems(pain, bladder, sex, rectum)
A one joint pain
B many joints pain
A Skin sensitivity
B Acne, rosacea
C Dermographism (can write on skin with finger)
D Skin hyperhemia (skin gets suddenly bright red)
A Dizziness - Loosing balance
B Feeling Very hot / Very cold
C Foggy brain
A Poor circulation
B Pins & needles
C Numbness
A Headaches
B Backpain
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
MALE
FEMALE
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO

Please enter the word that you see below.

  

That's it.  You will receive your mail with the appropriate mp3 within a week