Patient Questionnaire, v2.0

Have you tried to manage your weight with balanced, regular, healthy diet? When, did it work and for how long?
Do you suffer from any disease (Metabolic, pulmonary, heart, liver, nerve, muscle, gastric any other)? (Name, if Yes)
Privacy information. This personal information is collected and used only to provide you the best possible medical care and will not be spreaded to the third persons not involved in your medical treatment.
Please make sure you mark all answers Yes or No