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Looking for answers about
your unexplained symptoms?
Please answer the following questions:
Do you have pain or tingling
in your hands and/or feet?
Yes
No
Do you sweat very little
or not at all?
Yes
No
Do you have a spotted rash
between your belly button and knees?
Yes
No
Do you have a family history of heart failure, heart attacks or stroke?
Yes
No
I don’t know
Do you have a family history
of kidney disease?
Yes
No
I don’t know
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