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Black And White Bokeh

Thyroid Health Screening Questionnaire

Purpose

This questionnaire helps identify symptoms and risk factors that may suggest an underactive thyroid (hypothyroidism) or an overactive thyroid (hyperthyroidism).

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This questionnaire does not diagnose thyroid disease. If your answers suggest you may have a thyroid condition, blood tests such as TSH and Free T4 may be recommended.

Birthday Date
Month
Day
Year
Sex
Female
Male
Other
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