General Lifestyle Checklist

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Please assign a value between 0 and 4 for each symptom. 0 is Never or Non-existent, 1 is Occasionally, 2 is Often, 3 is Frequently, 4 is Always.
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Please do not submit any Protected Health Information (PHI).

Hours of Operation

Monday  

9:00 am - 6:00 pm

Tuesday  

9:00 am - 6:00 pm

Wednesday  

9:00 am - 6:00 pm

Thursday  

9:00 am - 6:00 pm

Friday  

9:00 am - 6:00 pm

Saturday  

9:00 am - 2:00 pm

Sunday  

Closed

Location

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