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Question 1 of 5
Are you over 18 years of age?
Yes
No
Question 2 of 5
Do you have medically diagnosed Endometriosis or Adenomyosis?
Question 3 of 5
Do you have medically diagnosed Irritable Bowel Syndrome (IBS)?
Question 4 of 5
Do you have small intestinal bacterial overgrowth (SIBO) or an eating disorder?
Question 5 of 5
Do you have any other medical history or information you would like to add? If yes, please list below, if not, please write "no".