GLOW questionnaire
PLEASE READ
All details are strictly confidential. Honest answers will maximise your benefits of the consultation. Answer only those questions that you find relevant, and tick only those symptoms that you experience on a regular basis and truly identify yourself with. If you don't know the answer or don't find the question relevant, do not answer.

IMPORTANT: Google Forms is not supported with auto-saving so it's impossible to start filling out the questionnaire and leave it for later. Also, when you click 'back' in your internet browser, all data will be lost. The questionnaire is long so please reserve the time to fill it out in one go, and once you complete a section, do not go back. Apologies for any inconvenience.

First name, last name *
Your answer
Age *
Your answer
Email *
Your answer
Mobile phone number *
Your answer
How would you like to be consulted? *
Skype ID
Your answer
Occupation *
Your answer
Height in centimetres *
Your answer
Weight in kilograms *
Your answer
How did you hear about GLOW?
Your answer
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