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Action Form: No Magic Pill

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)

abnormal pap smears acne allergy
appetite changes arthritic symptoms asthma
bad cholesterol benign liver tumours birth defects
blood clotting breakthrough bleeding breast cancer
cancer of the cervix cancerous growths cervical cancer
changes in blood lipids changes in the cervix changes in blood sugar levels
chicken pox chlamydial infection chlamydial infections of the cervix
chromosomal birth defects chronic candida clots
clotting in the blood vessel clotting complications cystic breast disease
developing breast cancer diabetes dizziness
early cervical cancer eczema epilepsy
excessive menstrual bleeding excessive hair growth EYE CHANGES
family history of breast cancer gallbladder disease gonorrhea
GUM DISEASE hair loss hardening of the arteries
heart disease heart attack heavy smoking
hepatitis herpes high blood pressure
incidence of breast cancer infections of the cervix infertility
internal bleeding irregular periods jaundice
Laparoscopic tubal ligation life-threatening emergency limb birth defects
liver tumours long-term pill users loss of hair
lowered sex drive lupus malignant melanoma
menstrual irregularities menstrual pain mood swings
ovarian cancer ovarian cysts pelvic infection
peptic ulcer pre-existing acne precancerous changes in the cervix
pulmonary embolus rheumatoid arthritis risk of blood clots
skin problems skin rashes skin cancer
smoking steroid use stroke
sudden blindness sunlight sensitivity swelling of the ankles
swelling tenderness of the breasts tenderness
thyroid cancer thyroid disease tubal pregnancy
ulcer ulcers in the mouth unprotected sex
urinary tract infections urinary tract cancer uterine cancer
varicose veins viral infection vitamin-B6 deficiency
vomiting weight gain yeast infection
yellow jaundice

Check off any of the following items that you ingest.

B vitamins bi-phasic or tri-phasic pill formulations chelated zinc
chicken CYLCEN desogestrel
folic acid gestodene insulin
liver enzymes MARVELON milk
norgestimate oral contraceptives ORTHOCEPT
ovral progesterones progestin
rashes steroid hormone steroid medication
sugar triglyceride vitamin-C

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

herbal treatment

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.

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