Medical History
Lung condition Heart condition Gastrointestinal condition Nervous or Psychiatric condition Blood disorders Blood-borne viruses Blood Pressure Problem Bone disease Back Problems Neck Problems Fainting Spells Eye conditions High Cholesterol Immune condition Tuberculosis or other respiratory disease Diabetes Liver disease Kidney disease Neurosurgery Smoking Prior hormone treatment Pregnancy CJD or related diseases Stroke Thyroid Skin Conditions Epilepsy or Seizures Dementia Other ongoing conditions