Nerve and Joint History 

Yes / No

Do you have frequent headaches?
Have you ever had convulsions?
Have you had headaches awaken you?
Do you have dizziness when turning your head? 
N
Do you have muscle pain?
N
Do you have joint pain?
N
Do you have ringing in your ears?
N
Are you ever light headed?
N
Do you have any numbness anywhere?
N

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©1999,  Herbert A. Yates, D.O. and Neal R. Chamberlain, Ph.D.. All rights reserved.