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In the last month:

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* 1. Have you felt keyed up or on edge?

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* 2. Have you been worrying a lot?

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* 3. Have you been irritable?

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* 4. Have you had any difficulty relaxing?

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* 5. Have you been sleeping poorly?

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* 6. Have you had headaches or neck aches?

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* 7. Have you had any of the following: Trembling, Tingling, Dizzy Spells, Sweating, Urinary Frequency or Diarrhoea?

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* 8. Have you been worried about your health?

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* 9. Have you had difficulty falling asleep?

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