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 1. Do you faint from even the slightest exertion?
     Yes      No

 2. Is your menstruation early, profuse, exhausting?
     Yes      No

 3. Do you suffer from leg cramps, abdominal, menstrual, with cold sweats?
     Yes      No

 4. Do your have constipation with abdominal pain, straining with cold sweats?
     Yes      No

 5. Do you experience diarrhea &/ or vomiting with a total exhaustion?
     Yes      No

 6. Are you worse with slightest motion?
     Yes      No

 7. Do you crave juicy fruits, ice, salt?
     Yes      No

 8. Does your illness leave you feeling weak, exhausted, can't even hold your head up?
     Yes      No

 9. Are your symptoms worse from cold, wet weather, exertion, hot drinks?
     Yes      No

 10. Are your symptoms better from covering up warmly, cold drinks?
     Yes      No

 11. Are you interested in more information on Veratrum Album &/ or finding your correct remedy?
     Yes      No

 12. Are you interested in buying this remedy separately/ in a homeopathic kit?
     Yes      No

 13. Are you interested in receiving our FREE Email Health Newsletter?
     Yes      No



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