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Are you at least 18 years of age?
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2
In which state do you live?
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3
Have you been diagnosed with an autoimmune condition?
Yes - by a Rheumatologist
Yes - by my Primary Care Provider (PCP)
Yes - by another specialty doctor
No
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4
What condition have you been diagnosed with?
Rheumatoid Arthritis
Psoriatic Arthritis
Ankylosing Spondylitis
Fibromyalgia
Lupus
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5
Has your PCP or other specialist advised you to see a Rheumatologist based on their evaluation or lab results?
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6
Name
First Name
Last Name
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7
Phone Number
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8
Email
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