Quality of Life Questions Question Title * Please enter your contact information Name * Address * Address 2 City/Town * State/Province * -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code * Email Address * Phone Number * Question Title * What is your date of birth? Question Title * How many years have you been searching for a diagnosis that matches the symptoms that you have been experiencing? If it has been less than 1 year, please enter "0." Question Title * Where do you experience swelling? You can select more than one item below Eyelids Lips Throat Tongue Digestive tract (stomach, intestines, rectum, etc.) Genitals Bladder Feet Other (please specify) Question Title * Please enter the name of your treating physician Question Title * Please enter the street address, city, state and zip code for your physician Question Title * Please enter your treatment status Waiting for test results to start treatment Been on treatment for 3 months Been on treatment for 6 months Been on treatment for 1 year Question Title * How would you describe your gender identity? Female she/her/hers Male he/him/his I prefer a description not listed they/them/theirs Question Title * How would you describe your ethnic/racial origin? European American Black or African American Hispanic American Asian American Middle Eastern American Native American or Alaska Native Native Hawaiian or Other Pacific Islander Two or more races Another race or ethnic origin not listed Next