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Please answer the questions below truthfully and completely, thank you. Feel free to access your my chart or look up anything that is not known. 

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* 1. Do you have fatigueability?

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* 2. Do you have current/ h/o right upper abdominal pain?

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* 3. Do you notice easy bleeding?

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* 4. Do you bruise easily?

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* 5. Have you had yellow discoloration in the hands and eyes

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* 6. Do you have itchy skin?

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* 7. Do you currently have or h/o fluid accumulation in the abdomen?

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* 8. Have you had a loss of appetite?

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* 9. Do you have persistent nausea?

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* 10. Have you noticed swelling in your legs?

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* 11. Have you noticed increase confusion?

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* 12. Have you had persistent drowsiness?

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* 13. Have you experienced slurred speech?

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* 14. Have you noticed blood vessels similar to a spider on your skin?

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* 15. Are you considered to be overweight or obese?

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* 16. Do you have diabetes?

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* 17. Do you have high cholesterol?

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* 18. Do you have a poor diet?

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* 19. Are your triglycerides elevated?

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* 20. Have you been diagnosed with metabolic syndrome?

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* 21. Do you have or h/o polycystic ovarian disease?

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* 22. Do you have sleep apnea?

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* 23. Do you have hypothyroidism? Have you been diagnosed with NASH?

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* 24. Have you been diagnosed with fatty liver disease?

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* 25. Have you had persistent elevation of liver function test?

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* 26. Is your BMI = or > 25

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* 27. Have you been diagnosed with liver fat > or = 8% via. MRI?

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* 28. Do you have biopsy-proven NASH?

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* 29. Do you have a history of hepatitis B?

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* 30. Do you have a history of hepatitis C?

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* 31. Do you have a history of alcohol abuse?

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* 32. Do you have a large waist circumference?

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* 33. Do you have an increased risk of heart disease?

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* 34. Do you have increased blood pressure?

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* 35. Do you have a low HDL?

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* 36. Would you like to be contacted and paid if your survey answers match a study? 

0 of 36 answered
 

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