Health Opinion Survey

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Answer the following:

	Often	Sometimes	Seldom	Never
Do you have a loss of appetite?	Often	Sometimes	Seldom	Never
Has any ill health affected the amount of work you do?	Often	Sometimes	Seldom	Never
Do your hands ever tremble enought to bother you?	Often	Sometimes	Seldom	Never
Are you ever bothered by nervousness?	Often	Sometimes	Seldom	Never
Do you tend to feel tired in the mornings?	Often	Sometimes	Seldom	Never