Your user number is 00000. Please write this number down, for future reference. The survey is long, and you might not complete it in one session. If you resume the survey later, this number will help us keep all your responses together.
(all tests, including tests to rule out other diseases, etc.)
If you marked "other" please specify:
If you marked "MRI" or "CT", please indicate which body part(s)? 1: 2:
Please fill out the table below.
In the first column "DIAG" mark if you got an official diagnosis for the condition mentioned. In the second column "TEST" if you were tested for this condition. In the third column "POS" if the test was positive (indicating you are likely to have the condition). In the fourth column "TREAT" if you were treated for this condition.
This is the end of Part 2.
Please press the Continue button to continue with Part 3 of this survey.