Please read the following carefully and inform us if you currently have, or have had in the past six months, any of the following symptoms/conditions:
Musculoskeletal
Strains / sprains / fractures/ myositis / joint replacement / arthritis / osteoporosis / bursitis / tendonitis / other
Neurological issues
Epilepsy / sciatica / neuralgia / MS / Parkinsons / other
Respiratory issues
Asthma / pneumonia / bronchitis / sinusitis / cold / cough / flu / other
Digestive issues
IBS / constipation / diarrhea / gall stones / kidney stones / UTI / other
Circulatory
Heart condition / hypertension / hypotension / DVT / phlebitis / varicose veins / haemophilia / CV disease / other
Skin Issues
Eczema / acne / athlete's foot / warts / dermatitis / psoriasis / impetigo / cuts / bruises / burns / undiagnosed lumps / other
Immune issues
Cancer / rheumatoid arthritis / HIV / AIDS / other
Miscellaneous issues
Diabetes / allergies / recent operations / pregnancy / glandular fever / headaches / psychological issues / menstrual issues / substance abuse / feeling unwell