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Take a moment to fill in the symptom questionnaire below. The medical symptom questionnaire identifies symptoms that help to identify the underlying causes of illness and help you track your progress over time. Rate each of the following symptoms based upon your health profile for the past 7 days. 

Key to Questionnaire: Optimal is less than 10 | Mild Toxicity: 10-50 | Moderate Toxicity: 50-100 | Severe Toxicity: over 100

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