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Right Hip
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Left Groin
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Right Groin
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Left Knee
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Right Knee
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Right Ankle
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Left Foot
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Right Foot
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Musculoskeletal
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Jaw Pain (TMJD)
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Myasthenia Gravis
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Dupuytren's Contracture
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Degenerative Disk Disease
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Ankylosing Spondylitis
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Chronic Fatigue Syndrome
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Compartment Syndrome
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Psoriatic Arthritis
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Sinus Problems
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Dislocation
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Gout
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Scleroderma
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Artificial Joints / Special Equipment
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Scoliosis
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Temporomandibular Joint Dysfunction
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Spondylolisthesis
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Carpal Tunnel Syndrome
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Strain/Sprain
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Amyotrophic Lateral Sclerosis (ALS)
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Fibromyalgia
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Arthritis
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Joint Injury
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Other Musculoskeletal
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Gastrointestinal
Diverticulitis
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Ulcerative Colitis
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Digestive Conditions
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Eating Disorder
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Esophageal Disorder
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Crohn's Disease
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Fecal Impaction
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Intestinal Polyps
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Irritable Bowel Syndrome
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Gastroparesis
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Celiac Disease
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Poor Appetite
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Constipation
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Diarrhea
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Stomach Disorder
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Neurological
Herniated Disc
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Syringomyelia
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Seizure Disorder
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Burning
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Sciatic Pain
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Cerebral-vascular Accident
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Multiple Sclerosis
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Tethered Cord
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Transient Ischemic Attacks (TIA)
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Tingling
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Vertebral and Spinal Cord Injury
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Cerebrospinal Fluid Leak
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Stroke
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Stabbing
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Loss of Sensation
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Huntington Disease
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Dural Ectasia
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Brain Disorder
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Chronic Pain Disorder
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Epilepsy
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Cerebral Palsy
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Brain Injury
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Shingles
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Parkinsons
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Chiari Malformation
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Cerebral Vascular Accident (Stroke)
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Numbness
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Dizziness
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Other Neurological
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Skin
Rosacea
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Surgical Scars
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Athletes Foot
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UV Burn
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Athlete's Foot
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Chemical Burn
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Hypersensitive Reaction
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Herpes
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Hypersensitive Reactions
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Melanoma/Carcinoma
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Bruise Easily
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Pigmentary Disorder
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Melanoma
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Plantar's Wart
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Eczema
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Psoriasis
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Skin Conditions
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Infectious Skin Conditions
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Acne
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Rash
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Non-Surgical Scars
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Skin Irritations
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Allergic Dermatosis
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Other Skin
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Cardiovascular
Hyperlipidemia
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Heart Attack
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Cardiovascular Conditions
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Aneurysm
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Varicose Veins
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Pericarditis
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Phlebitis
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Angina
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Raynaud Disease
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Blood Clots
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Atherosclerosis
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Cardiac Arrhythmia
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Rheumatic Heart Disease
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Cardiovascular Accident
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Lymphedema
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Chronic Ischemic Heart Disease
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Postural Orthostatic Tachycardia Syndrome
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Valve Disorders
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Pacemaker
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Chronic Venous Insufficiency
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High Blood Pressure
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Cold Hands
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Heart Disease
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Congenital Heart Defect
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Low Blood Pressure
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Cold Feet
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Coronary Artery Disease
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Congestive Heart Failure
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Blood Pressure
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Acute Coronary Syndrome
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Myocardial infarction
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Other Cardiovascular
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Reproductive
Pelvic Inflammatory Disease
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Premenstrual Syndrome
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Breast Disorder
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Uterine Disorder
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Ectopic Pregnancy
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Pregnancy
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Endometriosis
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Gynaecological Conditions
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Menopause
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Menstrual Cycle Disorder
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Ovarian Cysts/Tumors
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Other Reproductive
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Hearing
Motion Sickness
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Tinnitus
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Vertigo
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Ear Problems
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Hearing Loss
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Conductive Hearing Loss
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Meniere Disease
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Other Hearing
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Blood
HIV/AIDS
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Hepatitis
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Hypercoagulability
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Haemophilia
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HIV
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Polycythemia
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High Cholesterol
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Thrombosis/Embolism
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Anemia
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Bleeding Disorder
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Other Blood
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Endocrine
Acute Pancreatitis
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Hyperthyroidism
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Diabetes
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Hypothyroidism
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Prostate Condition
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Pituitary and Growth Disorder
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Other Endocrine
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Family History
Arthritis
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Cardiovascular
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Respiratory
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Immune
Hodgkin Lymphoma
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Rheumatoid Arthritis
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Allergies
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Infectious Mononucleosis
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Anaphylaxis
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Lupus
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Leukemia
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Cancer
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Non-Hodgkin Lymphoma
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Sjogren's Syndrome
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Other Immune
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Miscellaneous
Vision Problems
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Upper Respiratory Infection
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Vision Loss
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Weakened Immune Function
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Mental Health Issues
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ADHD
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Surgical Pins or Wire
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Liver Disease
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Insomnia
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Autism
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Music Preference
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Other Medical Conditions
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Other Diagnosed Diseases
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Prenatal (check boxes to enter details below)
Due Date
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Trimester
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Weeks Pregnant
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Number of previous pregnancies/births?
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Anemia
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Leaking Amniotic Fluid
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Bladder Infection
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Blood Clot (Phlebitis)
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Abdominal Cramping
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Diabetes
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Leg Cramps
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Preterm Labour
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Pre-eclampsia (toxemia)
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Sciatica
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Separation of Rectus Muscle (diastasis recti)
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Separation of Symphysis Pubis
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Twins or More
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Visual Disturbances
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Previous C-Section
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Heart Attack
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Stroke
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Carpal Tunnel Syndrome
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Allergy to Nut Oils
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Hypoglycemia
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High Risk Pregnancy
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Doula
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Placental Location
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Increases with Activity
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