MSQ30DAY

2nd Medical Symptoms Questionnaire After 30 days of taking Sun Horse

Now that you’ve been taking Sun Horse for 30 days fill out this same form with a 0-4 point scale to describe your symptoms, where: 0 = “Very weak, almost never” 4 = “Very frequent and severe.” We will see your progress to better health. Thank you for taking your herbs with us.
What Sun Horse Products you are taking?(Required)
Select at least 1 choice.
Name
Sun Horse Products (continued)
HEAD-Headaches(Required)
HEAD-Faintness(Required)
HEAD-Dizziness(Required)
HEAD-Insomnia(Required)
EYES-Watery or itchy eyes(Required)
EYES-Swollen, reddened or sticky eyelids(Required)
EYES-Bags or dark circles under eyes(Required)
EYES-Blurred or tunnel vision ( does not include near or farsightedness)(Required)
EARS-Itchy ears(Required)
EARS-Earaches, ear infections(Required)
EARS-Drainage from ear(Required)
EARS-Ringing in ears, hearing loss(Required)
NOSE-Stuffy Nose(Required)
NOSE-Sinus problems(Required)
NOSE-Hay fever(Required)
NOSE-Sneezing attacks(Required)
NOSE-Excessive mucus formation(Required)
MOUTH/THROAT-Chronic coughing(Required)
MOUTH/THROAT-Gagging, frequent need to clear throat(Required)
MOUTH/THROAT-Sore throat, hoarseness, loss of voice(Required)
MOUTH/THROAT-Swollen or discolored tongue, gums, lips(Required)
MOUTH/THROAT-Canker sores(Required)
SKIN-Acne(Required)
SKIN-Hives, rashes, dry skin(Required)
SKIN-Flushing, hot flashes(Required)
SKIN-Excessive sweating(Required)
HEART-Irregular or skipped heartbeat(Required)
HEART-Rapid or pounding heartbeat(Required)
HEART-Chest pain(Required)
LUNGS-Chest congestion(Required)
LUNGS-Asthma, bronchitis(Required)
LUNGS-Shortness of breath(Required)
LUNGS-Difficulty breathing(Required)
DIGESTIVE TRACT-Nausea, vomiting(Required)
DIGESTIVE TRACT-Diarrhea(Required)
DIGESTIVE TRACT-Constipation(Required)
DIGESTIVE TRACT-Bloated feeling(Required)
DIGESTIVE TRACT-Belching, passing gas(Required)
DIGESTIVE TRACT-Heartburn(Required)
DIGESTIVE TRACT-Intestinal/stomach pain(Required)
JOINTS/MUSCLE-Pain or aches in joints(Required)
JOINTS/MUSCLE-Arthritis(Required)
JOINTS/MUSCLE-Stiffness or limitation of movement(Required)
JOINTS/MUSCLE-Pain or aches in muscles(Required)
JOINTS/MUSCLE-Feeling of weakness or tiredness(Required)
BODY WEIGHT-Binge eating/drinking(Required)
BODY WEIGHT-Craving certain foods(Required)
BODY WEIGHT-Excessive weight(Required)
BODY WEIGHT-Compulsive eating(Required)
BODY WEIGHT-Water retention(Required)
BODY WEIGHT-Underweight(Required)
ENERGY/ACTIVITY-Fatigue, sluggishness(Required)
ENERGY/ACTIVITY-Apathy, lethargy(Required)
ENERGY/ACTIVITY-Hyperactivity(Required)
ENERGY/ACTIVITY-Restlessness(Required)
MIND-Poor memory(Required)
MIND-Confusion, poor comprehension(Required)
MIND-Poor concentration(Required)
MIND-Poor physical coordination(Required)
MIND-Difficulty in making decisions(Required)
MIND-Stuttering or stammering(Required)
MIND-Slurred speech(Required)
MIND-Learning disabilities(Required)
EMOTIONS-Mood swings(Required)
EMOTIONS-Anxiety, fear, nervousness(Required)
EMOTIONS-Anger, irritability, aggressiveness(Required)
EMOTIONS-Depression(Required)
OTHER-Frequent illness(Required)
Frequent or urgent urination(Required)
Genital itch or discharge(Required)