Powered by Typeform
Typeform uses its own and third party cookies for analytical and profiling / advertising purposes.
Cookie policy
Accept all
Reject all
Question 1
1
Do you experience numbness or tingling anywhere?
This question is required.
*
Key
A
Not at all
Key
B
Mildly, but it doesn't bother me much
Key
C
Moderately, it isn't pleasant at times
Key
D
Severely, it bothers me a lot
Question 2
2
Do you often feel hot?
This question is required.
*
Key
A
Not at all
Key
B
Mildly, but it doesn't bother me much
Key
C
Moderately, it isn't pleasant at times
Key
D
Severely, it bothers me a lot
