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Action Form: Beauty With Conscience

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)

Blindness blisters burns
convulsions diarrhea hemorrhage of the eye
hemorrhage signs of poisoning swelling
ulcer


Check off any of the following items that you ingest.

almond oil avocado histamine
rashes selenium


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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