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Survey on a physical symptom
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
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1
Do you ever currently experience feelings of light headedness?
Select one or more answers
Yes
No
2
If you answered yes to the previous question, how often on average do you experience light headedness?
3
What do you think might be the most likely causes of light headedness? If you have ever experienced it, what do you think caused it?
4
If you have felt light headed, what have you done to try and manage the feeling? How successful was this?
5
Have you ever experienced health anxiety? If yes, what health symptom were you anxious about and what was the outcome of this?
6
If you have ever experienced light headedness, what was the outcome of this? Did this symptom go away, or did it turn out to be a symptom of something else?
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