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Problem. * Write 1 in the box for MILD symptoms (occurs rarely). * Write 2 in the box for MODERATE symptoms (occurs several times a month). * Write 3 in the box for SEVERE symptoms (occurs almost constantly). Please do not use checkmarks in the boxes - fill in the boxes with a number or leave blank! GROUP 1 1 2 3 4 5 6 7 Acid foods upset Get chilled often "Lump" in throat Dry mouth-eyes-nose Pulse speeds after meal Keyed up - fail to calm Cut heals slowly 8 9 10 11 12 13 14 Gag easily Unable .

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