Endocrine History 

Yes / No

Any intolerance to hot or cold weather?
N
Do you ever have hot flashes?
Do you have excessive thirst?
N
Have you lost or gained more than 10 lbs? In the last 3 months? 
N
Do you have thyroid problems?

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©1999,  Herbert A. Yates, D.O. and Neal R. Chamberlain, Ph.D.. All rights reserved.