Symptom Checker Questionnaire

We have created our questionnaire based on the Green Climacteric Scale to help us better understand the severity of your symptoms and track how they change over time.

We will email you a copy of the report with a brief explanation so you can monitor and better understand your symptoms. Please note that we don’t retain a copy of your response or the email, so we suggest holding on to it for future reference or to share with us or another practitioner during a consultation.

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Symptom Checker Questionnaire
Name
Name
First
Last
Vasomotor
Not at all
A little
Quite often
All the time
Hot flushes and sweats during the day?
Night sweats or chills?
Insomnia or disturbed sleep?