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1. Do you or someone close to you have Psoriasis?
2. Have you or someone you care for been diagnosed with a sleep disorder characterized by excessive daytime sleepiness and/or sudden attacks of sleep?
3. Are you or a family member living with Crohns Disease (CD) or Ulcerative Colitis (UC), commonly referred to as Inflammatory Bowel Disease or IBD?
4. Under-active thyroid (Hypothyroidism) is a common condition mostly affecting women. Symptoms can include unexplained weight gain, cold sensitivity and fatigue. Do you or someone close to you have Hypothyroidism?
5. Have you or someone you care for been diagnosed with Epilepsy (Epilepsy is a seizure disorder that can affect anyone)?
6. Gastroesophageal Reflux Disease (GERD) and Eosinophilic Esophagitis (EOE) are different conditions with similar symptoms; heartburn/regurgitation, abdominal or chest pain and difficulty swallowing. Have you or a loved one been diagnosed with GERD or EOE?
7. Do you or someone close to you occasionally experience uncontrolled or involuntary movements like facial tics, movements around the mouth or rapid eye blinking? This could be a condition called Tardive Dyskinesia (TD) and can result from prolonged use of certain medications.
8. Are you or someone you care for diagnosed with Atrial Fibrillation, or AFib?
9. Have you or someone in your family been diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP), a rare condition characterized by progressive weakness and reduced senses in the arms and legs?
10. Have you or has someone you care for been diagnosed with Parkinsons Disease and is experiencing, or has experienced off-time while medicated?*
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