Allergic Rhinitis (hay fever) Yes |
Hypotension (low blood pressure)Yes |
Do you smoke? Please list how muchYes |
AsthmaYes |
Infectious DiseasesYes |
Cerebral vascular accident (stroke)Yes |
In growing nails (Onychocryptosis)Yes |
Chronic Fatigue SyndromeYes |
Lesser toe deformitiesYes |
Clinical DepressionYes |
Manic depression (bipolar state)Yes |
CellulitisYes |
Menopausal symptoms (flushing)Yes |
Diabetes (Indicate type I, II)Yes |
Morton’s neuroma painYes |
Deep vein thrombosis (blood clot)Yes |
MRSAYes |
EpilepsyYes |
Myocardial infarction (heart attack)Yes |
FibromyalgiaYes |
OsteoarthritisYes |
Hallux valgus (bunion deformity)Yes |
Plantar fasciitis (heel spur pain)Yes |
Hepatitis (indicate type A, B, C) Yes |
Pneumonia (or pleurisy) Yes |
HypercholesterolaemiaYes |
Rheumatoid arthritisYes |
Hypertension (high blood pressure)Yes |
Ulcer/Wound BreakdownYes |
Other ConditionsYes |
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