Action Form: Fading Fast: Women And Chronic Fatigue Section-1 Details Action Form: How To Cut Down On Stress
Go To Text Page: How Much Stress Are You Under ?

Action Form: How Much Stress Are You Under ?

If you had a medical diagnosis, how difficult was it to get a correct one?
Don't Know Easy Difficult Impossible

What kind of experience have you had with the medical profession?
Don't Know Bad Good Excellent

If you used a alternative practitioner, what kind of experience did you have?
Don't Know Bad Good Excellent

What did you find worked for you?
Stress Reduction Vitamins Herbs Diet Change
Prescription Drugs Exercise Time-Off Body Work

Who would you like to be informed about this subject?
Medical Associations Government Regulatory Agencies Elected Representatives Drug and Supplement Manufacturing Companies


What following conditions do you think apply to you. (Check anything that might apply)

Abuse of prescription agitation anorexia
backache chronic pain chronic fatigue
Chronic illness Chronic sleep lack Chronic yeast
Complicated pregnancy Death of a child difficult menopause
difficulty sleeping dizziness drug addiction
economic stress family violence financial difficulties
grief reaction grief harassment
headache heart disease heartburn
high blood pressure hot flashes infertility
irritability loss of appetite major stress
marital problems marriage breakdown mastectomy
menstrual difficulties mood swings outbursts of anger
outbursts PMS poor diet
sexual abuse Sexual harassment sleep problems
sleep lack sleep deprivation smoking
suicide Traumatic delivery ulcer
uncontrollable rages unrealistic expectations unspoken expectations
upsets vaginal infection


Check off any of the following items that you ingest.

bread junk food sugar


Check off any of the following therapies or procedures you use.

dieting healthy sex Marital reconciliation
satisfying sex stress relief


Make your imput count. The information you submit will be compliled with all other submissions and used to activate for positive change in women's health.

To The Top Of This Page