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vitaliza INFUSIONS - Lista de síntomas
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1
Nombre
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Nombre de pila
Apellido
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2
Celular
*
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Please enter a valid phone number.
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3
Email
*
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ejemplo@ejemplo.com
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4
Género
*
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Seleccione un sexo para mostrar los síntomas
Hombre
Mujer
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5
Fatiga
*
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Nunca
Leve
Moderado
Severo
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6
Cambios de humor
*
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Nunca
Leve
Moderado
Severo
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7
Confusión mental
*
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Nunca
Leve
Moderado
Severo
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8
Sudoración excesiva
*
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Nunca
Leve
Moderado
Severo
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9
Sofocos / Sudores nocturnos
*
This field is required.
Nunca
Leve
Moderado
Severo
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10
Aumento de peso
*
This field is required.
Nunca
Leve
Moderado
Severo
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11
Disminucion de deseo sexual/libido
*
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Nunca
Leve
Moderado
Severo
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12
Disminucion de capacidad para hacer sexo
*
This field is required.
Nunca
Leve
Moderado
Severo
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13
Problemas para dormir
*
This field is required.
Nunca
Leve
Moderado
Severo
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14
Disminución de la fuerza muscular
*
This field is required.
Nunca
Leve
Moderado
Severo
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15
Frio todo el tiempo
*
This field is required.
Nunca
Leve
Moderado
Severo
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16
Pérdida de cabello
*
This field is required.
Nunca
Leve
Moderado
Severo
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17
Dolor muscular y de articulaciones
*
This field is required.
Nunca
Leve
Moderado
Severo
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18
en todo el cuerpo Caída/rotura del cabello
*
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Nunca
Leve
Moderado
Severo
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19
Piel seca y arrugada
*
This field is required.
Nunca
Leve
Moderado
Severo
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20
Historia Familiar Femenina
*
This field is required.
Check All That Apply
Enfermedad del cardiaca
Diabetes
Osteoporosis
La enfermedad de Alzheimer
Cáncer de mama
N/A
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21
Historia Familiar Masulino
*
This field is required.
Check All That Apply
Enfermedad del cardiaca
Diabetes
Osteoporosis
Alzheimer's Disease
Cáncer de próstata
N/A
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22
Otros sintomas que le preocupen
*
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Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
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