Please indicate 0 - NO or 3 - YES regarding issues during your childhood.
Please use the following to indicate relevance of each concern below:
0- Does not apply | 1-Rarely | 2-Sometimes | 3-Applies | 4- Strongly Applies
Number of days with symptoms of autoimmune flare in the past month in the past week blanks* .
Number of days of inflammation** in the past month in the past week blanks* . **Can be body inflammation (aches &pains, body fatigue, GI symptoms, etc.) or brain inflammation (mental fatigue, brain fog, etc).