ALL ABOUT ME

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* 1. Gender:

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* 4. My disorder/disease:
(please write the full name)

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* 5. I have this disorder/disease for:

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* 6. Marital status:

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* 7. Do you have children?

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* 8. How often do you:

  Every day At least 3 times a week Once a week A few times a month Once a month Almost never
Exercise
Socialise with friends
Participate in a hobby
Eat healthy

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