{"id":2074,"date":"2023-05-22T15:35:41","date_gmt":"2023-05-22T15:35:41","guid":{"rendered":"https:\/\/www.drcopehealth.com\/?page_id=2074"},"modified":"2023-08-30T15:02:26","modified_gmt":"2023-08-30T15:02:26","slug":"hormone-quiz","status":"publish","type":"page","link":"https:\/\/www.drcopehealth.com\/quizes\/hormone-quiz\/","title":{"rendered":"Hormone Quiz"},"content":{"rendered":"\n<section class=\"quiz-container cc-sct\"><div class=\"-wrapper cc-wrapper\"><div class='fluentform ff-default fluentform_wrapper_7  ff_guten_block ffs_default_wrap'><form data-form_id=\"7\" id=\"fluentform_7\" class=\"frm-fluent-form fluent_form_7 ff-el-form-top ff_form_instance_7_1 ff-form-loading ff-form-has-steps ffs_default\" data-form_instance=\"ff_form_instance_7_1\" method=\"POST\" ><fieldset  style=\"border: none!important;margin: 0!important;padding: 0!important;background-color: transparent!important;box-shadow: none!important;outline: none!important; min-inline-size: 100%;\">\n                    <legend class=\"ff_screen_reader_title\" style=\"display: block; margin: 0!important;padding: 0!important;height: 0!important;text-indent: -999999px;width: 0!important;overflow:hidden;\">Hormone Quiz<\/legend>        <span style=\"display: none !important;\"><input type=\"checkbox\"\n                name=\"item__7__fluent_checkme_\"\n                value=\"1\" style=\"display:none !important;\" tabindex=\"-1\" aria-hidden=\"true\"><\/span>\n        <input type='hidden' name='__fluent_form_embded_post_id' value='2074' \/><input type=\"hidden\" id=\"_fluentform_7_fluentformnonce\" name=\"_fluentform_7_fluentformnonce\" value=\"79daf98130\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/pages\/2074\" \/><div class='ff-step-container' data-name=\"step_start-7_13\" data-disable_auto_focus=\"no\" data-enable_auto_slider=\"no\" data-enable_step_data_persistency=\"no\" data-enable_step_page_resume=\"no\" data-animation_type=\"fade\" ><span class='ff_step_start'><\/span><div class='ff-step-body'><div class=\"fluentform-step active\" data-name=\"step_start-7_13\" data-disable_auto_focus=\"no\" data-enable_auto_slider=\"no\" data-enable_step_data_persistency=\"no\" data-enable_step_page_resume=\"no\" data-animation_type=\"fade\" ><div data-name=\"welcome_screen-7_1\" class=\"ff-el-group ff-el-section-break  ff_center\" ><h3 class='ff-el-section-title'>Are your hormones imbalanced?<\/h3><div class='ff-section_break_desk'><p>In less than 5 minutes, discover the cause of <em>and<\/em> receive a customized treatment plan for your irregular periods, recurring miscarriages, fatigue, cramps, and more.<\/p>\n<p>&nbsp;<\/p><\/div><\/div><div class='step-nav ff_step_nav_last'><button tabindex='1'  type='button' data-action='prev' class='ff-btn ff-btn-prev ff-btn-secondary'>Previous<\/button><button tabindex='2'  type='button' data-action='next' class='ff-float-right ff-btn ff-btn-next ff-btn-secondary'>Next<\/button><\/div><\/div><div class=\" fluentform-step\" data-name=\"form_step-7_2\" ><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  aria-label=\"Let&#039;s start with periods. When it comes to your period, do you have...\">Let&#8217;s start with periods. When it comes to your period, do you have&#8230;<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=periods_12ab2ed7b96a24afbb191917253c6899><input  type=\"checkbox\" name=\"periods[]\" data-name=\"periods\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"3\" value=\"Heavy periods\" data-calc_value=\"7\"  id='periods_12ab2ed7b96a24afbb191917253c6899' aria-label='Heavy periods' aria-invalid='false' aria-required=false> <span>Heavy periods<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=periods_5ad5228f3dd17fb5d34bc381db6f517c><input  type=\"checkbox\" name=\"periods[]\" data-name=\"periods\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Painful periods\" data-calc_value=\"1\"  id='periods_5ad5228f3dd17fb5d34bc381db6f517c' aria-label='Painful periods' aria-invalid='false' aria-required=false> <span>Painful periods<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=periods_9e8732c1f7baebaae1a68e45fba97023><input  type=\"checkbox\" name=\"periods[]\" data-name=\"periods\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Irregular periods\" data-calc_value=\"4\"  id='periods_9e8732c1f7baebaae1a68e45fba97023' aria-label='Irregular periods' aria-invalid='false' aria-required=false> <span>Irregular periods<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=periods_fb5c49161bce10ce1649f05e8fcd3804><input  type=\"checkbox\" name=\"periods[]\" data-name=\"periods\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Absent periods \" data-calc_value=\"2\"  id='periods_fb5c49161bce10ce1649f05e8fcd3804' aria-label='Absent periods ' aria-invalid='false' aria-required=false> <span>Absent periods <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=periods_653c49530bbac64156f5b6881c3bf22b><input  type=\"checkbox\" name=\"periods[]\" data-name=\"periods\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Skipped periods\" data-calc_value=\"7\"  id='periods_653c49530bbac64156f5b6881c3bf22b' aria-label='Skipped periods' aria-invalid='false' aria-required=false> <span>Skipped periods<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=periods_0212b065725759f8315ac649d4c4cf81><input  type=\"checkbox\" name=\"periods[]\" data-name=\"periods\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Short menstrual cycles (&lt;21 days)\" data-calc_value=\"1\"  id='periods_0212b065725759f8315ac649d4c4cf81' aria-label='Short menstrual cycles (&lt;21 days)' aria-invalid='false' aria-required=false> <span>Short menstrual cycles (<21 days)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=periods_136b58ad0af0ae9cbbd559d84daf202f><input  type=\"checkbox\" name=\"periods[]\" data-name=\"periods\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Irregular menstrual cycles \" data-calc_value=\"3\"  id='periods_136b58ad0af0ae9cbbd559d84daf202f' aria-label='Irregular menstrual cycles ' aria-invalid='false' aria-required=false> <span>Irregular menstrual cycles <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=periods_ce1ba0771448d4f785ca41a1402b9c1d><input  type=\"checkbox\" name=\"periods[]\" data-name=\"periods\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Menstrual migraines\" data-calc_value=\"1\"  id='periods_ce1ba0771448d4f785ca41a1402b9c1d' aria-label='Menstrual migraines' aria-invalid='false' aria-required=false> <span>Menstrual migraines<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=periods_92acf61eb898f104dc2e1def025e7695><input  type=\"checkbox\" name=\"periods[]\" data-name=\"periods\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Long menstrual cycles or scant periods \" data-calc_value=\"2\"  id='periods_92acf61eb898f104dc2e1def025e7695' aria-label='Long menstrual cycles or scant periods ' aria-invalid='false' aria-required=false> <span>Long menstrual cycles or scant periods <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=periods_956641c1c3d8edbf90112b84caf70e27><input  type=\"checkbox\" name=\"periods[]\" data-name=\"periods\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"None of the above\" data-calc_value=\"0\"  id='periods_956641c1c3d8edbf90112b84caf70e27' aria-label='None of the above' aria-invalid='false' aria-required=false> <span>None of the above<\/span><\/label><\/div><\/div><\/div><div class='step-nav ff_step_nav_last'><button tabindex='4'  type='button' data-action='prev' class='ff-btn ff-btn-prev ff-btn-secondary'>Previous<\/button><button tabindex='5'  type='button' data-action='next' class='ff-float-right ff-btn ff-btn-next ff-btn-secondary'>Next<\/button><\/div><\/div><div class=\" fluentform-step\" data-name=\"form_step-7_3\" ><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  aria-label=\"How about your cycle?\">How about your cycle?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=cycle_7594bd57d8af284190049d152d643ab8><input  type=\"checkbox\" name=\"cycle[]\" data-name=\"cycle\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"6\" value=\"Short menstrual cycles (&lt;21 days)\" data-calc_value=\"1\"  id='cycle_7594bd57d8af284190049d152d643ab8' aria-label='Short menstrual cycles (&lt;21 days)' aria-invalid='false' aria-required=false> <span>Short menstrual cycles (<21 days)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=cycle_a9362e8ef87a03d94d3f898134f63bff><input  type=\"checkbox\" name=\"cycle[]\" data-name=\"cycle\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Irregular menstrual cycles \" data-calc_value=\"6\"  id='cycle_a9362e8ef87a03d94d3f898134f63bff' aria-label='Irregular menstrual cycles ' aria-invalid='false' aria-required=false> <span>Irregular menstrual cycles <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=cycle_0d42ad1a0a1b801297d1c3f361249554><input  type=\"checkbox\" name=\"cycle[]\" data-name=\"cycle\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Long menstrual cycles or scant periods \" data-calc_value=\"2\"  id='cycle_0d42ad1a0a1b801297d1c3f361249554' aria-label='Long menstrual cycles or scant periods ' aria-invalid='false' aria-required=false> <span>Long menstrual cycles or scant periods <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=cycle_d91d6d7109c65af5bae1416c1c4208c5><input  type=\"checkbox\" name=\"cycle[]\" data-name=\"cycle\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Menstrual migraines\" data-calc_value=\"1\"  id='cycle_d91d6d7109c65af5bae1416c1c4208c5' aria-label='Menstrual migraines' aria-invalid='false' aria-required=false> <span>Menstrual migraines<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=cycle_652c7f8e69dede60a64cc7644c15a6d7><input  type=\"checkbox\" name=\"cycle[]\" data-name=\"cycle\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"PMS\" data-calc_value=\"7\"  id='cycle_652c7f8e69dede60a64cc7644c15a6d7' aria-label='PMS' aria-invalid='false' aria-required=false> <span>PMS<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=cycle_0c18609a80ad31fc46a631c24bd84dc8><input  type=\"checkbox\" name=\"cycle[]\" data-name=\"cycle\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Short luteal phase (ovulation to menstruation less than 12 days)\" data-calc_value=\"3\"  id='cycle_0c18609a80ad31fc46a631c24bd84dc8' aria-label='Short luteal phase (ovulation to menstruation less than 12 days)' aria-invalid='false' aria-required=false> <span>Short luteal phase (ovulation to menstruation less than 12 days)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=cycle_6ff9e36cd36032edcad333f27610b123><input  type=\"checkbox\" name=\"cycle[]\" data-name=\"cycle\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Spotting in the second half of your cycle\" data-calc_value=\"3\"  id='cycle_6ff9e36cd36032edcad333f27610b123' aria-label='Spotting in the second half of your cycle' aria-invalid='false' aria-required=false> <span>Spotting in the second half of your cycle<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=cycle_9585758046d3d9dbb7ca92da8a5dc54e><input  type=\"checkbox\" name=\"cycle[]\" data-name=\"cycle\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Low or no signs of ovulation\" data-calc_value=\"3\"  id='cycle_9585758046d3d9dbb7ca92da8a5dc54e' aria-label='Low or no signs of ovulation' aria-invalid='false' aria-required=false> <span>Low or no signs of ovulation<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=cycle_ba07389da9156c34d9096c48e9881a3d><input  type=\"checkbox\" name=\"cycle[]\" data-name=\"cycle\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Low basal body temp in the luteal phase\" data-calc_value=\"3\"  id='cycle_ba07389da9156c34d9096c48e9881a3d' aria-label='Low basal body temp in the luteal phase' aria-invalid='false' aria-required=false> <span>Low basal body temp in the luteal phase<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=cycle_b2af3b50493996c99b6f6eebd6d38985><input  type=\"checkbox\" name=\"cycle[]\" data-name=\"cycle\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Miserable menopausal symptoms\" data-calc_value=\"6\"  id='cycle_b2af3b50493996c99b6f6eebd6d38985' aria-label='Miserable menopausal symptoms' aria-invalid='false' aria-required=false> <span>Miserable menopausal symptoms<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=cycle_ba85e5159509f7a5a6c6a8999a58e5e5><input  type=\"checkbox\" name=\"cycle[]\" data-name=\"cycle\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"None of the above\" data-calc_value=\"0\"  id='cycle_ba85e5159509f7a5a6c6a8999a58e5e5' aria-label='None of the above' aria-invalid='false' aria-required=false> <span>None of the above<\/span><\/label><\/div><\/div><\/div><div class='step-nav ff_step_nav_last'><button tabindex='7'  type='button' data-action='prev' class='ff-btn ff-btn-prev ff-btn-secondary'>Previous<\/button><button tabindex='8'  type='button' data-action='next' class='ff-float-right ff-btn ff-btn-next ff-btn-secondary'>Next<\/button><\/div><\/div><div class=\" fluentform-step\" data-name=\"form_step-7_4\" ><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  aria-label=\"You&#039;re doing great! When it comes to your general mood, do you find you experience...\">You&#8217;re doing great! When it comes to your general mood, do you find you experience&#8230;<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=mood_ff32b8e0ee3bdfa2879db5d0379ca9d4><input  type=\"checkbox\" name=\"mood[]\" data-name=\"mood\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"9\" value=\"Mood swings\" data-calc_value=\"1\"  id='mood_ff32b8e0ee3bdfa2879db5d0379ca9d4' aria-label='Mood swings' aria-invalid='false' aria-required=false> <span>Mood swings<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=mood_c97be237af785222ae9a4afed7768fb1><input  type=\"checkbox\" name=\"mood[]\" data-name=\"mood\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Anxiety \" data-calc_value=\"3\"  id='mood_c97be237af785222ae9a4afed7768fb1' aria-label='Anxiety ' aria-invalid='false' aria-required=false> <span>Anxiety <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=mood_d9273af3375da2015db71fa1b2fed3ee><input  type=\"checkbox\" name=\"mood[]\" data-name=\"mood\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Aggression, irritability\" data-calc_value=\"4\"  id='mood_d9273af3375da2015db71fa1b2fed3ee' aria-label='Aggression, irritability' aria-invalid='false' aria-required=false> <span>Aggression, irritability<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=mood_aefcf6b00004cab6bbc78dcba2b2721f><input  type=\"checkbox\" name=\"mood[]\" data-name=\"mood\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Low motivation\" data-calc_value=\"6\"  id='mood_aefcf6b00004cab6bbc78dcba2b2721f' aria-label='Low motivation' aria-invalid='false' aria-required=false> <span>Low motivation<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=mood_2696bf9965f0c5567838444be5a7ace5><input  type=\"checkbox\" name=\"mood[]\" data-name=\"mood\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Feeling &quot;blue&quot; or depressed\" data-calc_value=\"6\"  id='mood_2696bf9965f0c5567838444be5a7ace5' aria-label='Feeling &quot;blue&quot; or depressed' aria-invalid='false' aria-required=false> <span>Feeling &#8220;blue&#8221; or depressed<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=mood_c92a0f6159a5b759a22f8197654a946e><input  type=\"checkbox\" name=\"mood[]\" data-name=\"mood\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Chronic stress, overwhelm \" data-calc_value=\"6\"  id='mood_c92a0f6159a5b759a22f8197654a946e' aria-label='Chronic stress, overwhelm ' aria-invalid='false' aria-required=false> <span>Chronic stress, overwhelm <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=mood_1006af877993fd40f2ead69bb7779242><input  type=\"checkbox\" name=\"mood[]\" data-name=\"mood\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Often feeling burnout \" data-calc_value=\"6\"  id='mood_1006af877993fd40f2ead69bb7779242' aria-label='Often feeling burnout ' aria-invalid='false' aria-required=false> <span>Often feeling burnout <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=mood_ea3ad4af20b37564fda865d5f5b46995><input  type=\"checkbox\" name=\"mood[]\" data-name=\"mood\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Mood swings, PMS, irritability, weepiness, mini breakdowns, or anxiety\" data-calc_value=\"6\"  id='mood_ea3ad4af20b37564fda865d5f5b46995' aria-label='Mood swings, PMS, irritability, weepiness, mini breakdowns, or anxiety' aria-invalid='false' aria-required=false> <span>Mood swings, PMS, irritability, weepiness, mini breakdowns, or anxiety<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=mood_65e6937f6243d731b44b5fd0223c6feb><input  type=\"checkbox\" name=\"mood[]\" data-name=\"mood\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Low mood\" data-calc_value=\"7\"  id='mood_65e6937f6243d731b44b5fd0223c6feb' aria-label='Low mood' aria-invalid='false' aria-required=false> <span>Low mood<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=mood_59bf1eaf864f87ab181af81a04cd5e3f><input  type=\"checkbox\" name=\"mood[]\" data-name=\"mood\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"None of the above\" data-calc_value=\"0\"  id='mood_59bf1eaf864f87ab181af81a04cd5e3f' aria-label='None of the above' aria-invalid='false' aria-required=false> <span>None of the above<\/span><\/label><\/div><\/div><\/div><div class='step-nav ff_step_nav_last'><button tabindex='10'  type='button' data-action='prev' class='ff-btn ff-btn-prev ff-btn-secondary'>Previous<\/button><button tabindex='11'  type='button' data-action='next' class='ff-float-right ff-btn ff-btn-next ff-btn-secondary'>Next<\/button><\/div><\/div><div class=\" fluentform-step\" data-name=\"form_step-7_5\" ><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  aria-label=\"And how about your sex drive?\">And how about your sex drive?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=sex_drive_a4b36a3fa044467a9dee0b16f2ac353f><input  type=\"checkbox\" name=\"sex_drive[]\" data-name=\"sex_drive\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"12\" value=\"Low libido\" data-calc_value=\"1\"  id='sex_drive_a4b36a3fa044467a9dee0b16f2ac353f' aria-label='Low libido' aria-invalid='false' aria-required=false> <span>Low libido<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=sex_drive_588043db516ce45d36b68021033743b6><input  type=\"checkbox\" name=\"sex_drive[]\" data-name=\"sex_drive\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Low (or no) sex drive\" data-calc_value=\"6\"  id='sex_drive_588043db516ce45d36b68021033743b6' aria-label='Low (or no) sex drive' aria-invalid='false' aria-required=false> <span>Low (or no) sex drive<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=sex_drive_29819abaca9efe013dcde6cc923c0456><input  type=\"checkbox\" name=\"sex_drive[]\" data-name=\"sex_drive\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Decreased sexual satisfaction, difficulty achieving orgasm\" data-calc_value=\"5\"  id='sex_drive_29819abaca9efe013dcde6cc923c0456' aria-label='Decreased sexual satisfaction, difficulty achieving orgasm' aria-invalid='false' aria-required=false> <span>Decreased sexual satisfaction, difficulty achieving orgasm<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=sex_drive_529c041abd6226ec4edffece464d63a2><input  type=\"checkbox\" name=\"sex_drive[]\" data-name=\"sex_drive\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"None of the above\" data-calc_value=\"0\"  id='sex_drive_529c041abd6226ec4edffece464d63a2' aria-label='None of the above' aria-invalid='false' aria-required=false> <span>None of the above<\/span><\/label><\/div><\/div><\/div><div class='step-nav ff_step_nav_last'><button tabindex='13'  type='button' data-action='prev' class='ff-btn ff-btn-prev ff-btn-secondary'>Previous<\/button><button tabindex='14'  type='button' data-action='next' class='ff-float-right ff-btn ff-btn-next ff-btn-secondary'>Next<\/button><\/div><\/div><div class=\" fluentform-step\" data-name=\"form_step-7_6\" ><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  aria-label=\"How&#039;s your sleep lately?\">How&#8217;s your sleep lately?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=sleep_cbbef555762f5f9f97abeab1456401a3><input  type=\"checkbox\" name=\"sleep[]\" data-name=\"sleep\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"15\" value=\"Trouble falling asleep, waking in the middle of the night \" data-calc_value=\"2\"  id='sleep_cbbef555762f5f9f97abeab1456401a3' aria-label='Trouble falling asleep, waking in the middle of the night ' aria-invalid='false' aria-required=false> <span>Trouble falling asleep, waking in the middle of the night <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=sleep_536e7a0f5a27c3ab5ac70c70f48b9b0d><input  type=\"checkbox\" name=\"sleep[]\" data-name=\"sleep\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Insomnia, trouble falling asleep or staying asleep \" data-calc_value=\"6\"  id='sleep_536e7a0f5a27c3ab5ac70c70f48b9b0d' aria-label='Insomnia, trouble falling asleep or staying asleep ' aria-invalid='false' aria-required=false> <span>Insomnia, trouble falling asleep or staying asleep <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=sleep_5a68f8b83c9e4d29087b4d88995dedf9><input  type=\"checkbox\" name=\"sleep[]\" data-name=\"sleep\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Sleep disturbances\" data-calc_value=\"5\"  id='sleep_5a68f8b83c9e4d29087b4d88995dedf9' aria-label='Sleep disturbances' aria-invalid='false' aria-required=false> <span>Sleep disturbances<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=sleep_92ab1c8d773762ad6325432c051a4869><input  type=\"checkbox\" name=\"sleep[]\" data-name=\"sleep\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Trouble falling asleep, feeling &quot;tired and wired&quot; \" data-calc_value=\"6\"  id='sleep_92ab1c8d773762ad6325432c051a4869' aria-label='Trouble falling asleep, feeling &quot;tired and wired&quot; ' aria-invalid='false' aria-required=false> <span>Trouble falling asleep, feeling &#8220;tired and wired&#8221; <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=sleep_01eef3311ff76dda6117489d74dfee21><input  type=\"checkbox\" name=\"sleep[]\" data-name=\"sleep\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Tired during the day, hit a slump around 3-4 p.m. \" data-calc_value=\"6\"  id='sleep_01eef3311ff76dda6117489d74dfee21' aria-label='Tired during the day, hit a slump around 3-4 p.m. ' aria-invalid='false' aria-required=false> <span>Tired during the day, hit a slump around 3-4 p.m. <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=sleep_ccbc7a9c7a0748c18b509ec1628a836b><input  type=\"checkbox\" name=\"sleep[]\" data-name=\"sleep\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Waking up tired even after a good night's sleep\" data-calc_value=\"6\"  id='sleep_ccbc7a9c7a0748c18b509ec1628a836b' aria-label='Waking up tired even after a good night&#039;s sleep' aria-invalid='false' aria-required=false> <span>Waking up tired even after a good night&#8217;s sleep<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=sleep_72cca61fcfc962a2f3643aa4cd9c6e6e><input  type=\"checkbox\" name=\"sleep[]\" data-name=\"sleep\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"None of the above\" data-calc_value=\"0\"  id='sleep_72cca61fcfc962a2f3643aa4cd9c6e6e' aria-label='None of the above' aria-invalid='false' aria-required=false> <span>None of the above<\/span><\/label><\/div><\/div><\/div><div class='step-nav ff_step_nav_last'><button tabindex='16'  type='button' data-action='prev' class='ff-btn ff-btn-prev ff-btn-secondary'>Previous<\/button><button tabindex='17'  type='button' data-action='next' class='ff-float-right ff-btn ff-btn-next ff-btn-secondary'>Next<\/button><\/div><\/div><div class=\" fluentform-step\" data-name=\"form_step-7_7\" ><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  aria-label=\"How about your overall energy levels and concentration?\">How about your overall energy levels and concentration?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=energy_3468588ee45ddbf281733c8bae296ae1><input  type=\"checkbox\" name=\"energy[]\" data-name=\"energy\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"18\" value=\"Headaches or migraines\" data-calc_value=\"3\"  id='energy_3468588ee45ddbf281733c8bae296ae1' aria-label='Headaches or migraines' aria-invalid='false' aria-required=false> <span>Headaches or migraines<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=energy_0529f5bc253ddc2ca04512cc0412c8ad><input  type=\"checkbox\" name=\"energy[]\" data-name=\"energy\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Brain fog, memory problems, poor focus \" data-calc_value=\"2\"  id='energy_0529f5bc253ddc2ca04512cc0412c8ad' aria-label='Brain fog, memory problems, poor focus ' aria-invalid='false' aria-required=false> <span>Brain fog, memory problems, poor focus <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=energy_dabd4e12ac0659810ee2581fa292392e><input  type=\"checkbox\" name=\"energy[]\" data-name=\"energy\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Sluggishness, fatigue, zero energy \" data-calc_value=\"7\"  id='energy_dabd4e12ac0659810ee2581fa292392e' aria-label='Sluggishness, fatigue, zero energy ' aria-invalid='false' aria-required=false> <span>Sluggishness, fatigue, zero energy <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=energy_abc7bc878cd19a71ba0b27248810f362><input  type=\"checkbox\" name=\"energy[]\" data-name=\"energy\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Needing coffee to start the day, or a cup in the afternoon \" data-calc_value=\"6\"  id='energy_abc7bc878cd19a71ba0b27248810f362' aria-label='Needing coffee to start the day, or a cup in the afternoon ' aria-invalid='false' aria-required=false> <span>Needing coffee to start the day, or a cup in the afternoon <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=energy_bb2a7f1e6b69f1af9b2bbc2c63bcad16><input  type=\"checkbox\" name=\"energy[]\" data-name=\"energy\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"My memory and concentration aren't what they were \" data-calc_value=\"7\"  id='energy_bb2a7f1e6b69f1af9b2bbc2c63bcad16' aria-label='My memory and concentration aren&#039;t what they were ' aria-invalid='false' aria-required=false> <span>My memory and concentration aren&#8217;t what they were <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=energy_8b1ed4cd341914f941caac5abd2e0f0b><input  type=\"checkbox\" name=\"energy[]\" data-name=\"energy\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Tired a lot \" data-calc_value=\"8\"  id='energy_8b1ed4cd341914f941caac5abd2e0f0b' aria-label='Tired a lot ' aria-invalid='false' aria-required=false> <span>Tired a lot <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=energy_3536d49c3c3326aa4747447d45767d5c><input  type=\"checkbox\" name=\"energy[]\" data-name=\"energy\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"None of the above\" data-calc_value=\"0\"  id='energy_3536d49c3c3326aa4747447d45767d5c' aria-label='None of the above' aria-invalid='false' aria-required=false> <span>None of the above<\/span><\/label><\/div><\/div><\/div><div class='step-nav ff_step_nav_last'><button tabindex='19'  type='button' data-action='prev' class='ff-btn ff-btn-prev ff-btn-secondary'>Previous<\/button><button tabindex='20'  type='button' data-action='next' class='ff-float-right ff-btn ff-btn-next ff-btn-secondary'>Next<\/button><\/div><\/div><div class=\" fluentform-step\" data-name=\"form_step-7_8\" ><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  aria-label=\"You&#039;re almost done! Just a few more questions. Are you experiencing any of the following?\">You&#8217;re almost done! Just a few more questions. Are you experiencing any of the following?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=current_symptoms_78fa173272629168981b3619f97ea1c1><input  type=\"checkbox\" name=\"current_symptoms[]\" data-name=\"current_symptoms\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"21\" value=\"Bloating, puffiness, or fluid retention \" data-calc_value=\"6\"  id='current_symptoms_78fa173272629168981b3619f97ea1c1' aria-label='Bloating, puffiness, or fluid retention ' aria-invalid='false' aria-required=false> <span>Bloating, puffiness, or fluid retention <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=current_symptoms_e0bcad2d8758c32dc754cd2581a95201><input  type=\"checkbox\" name=\"current_symptoms[]\" data-name=\"current_symptoms\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Breast tenderness, cysts\" data-calc_value=\"1\"  id='current_symptoms_e0bcad2d8758c32dc754cd2581a95201' aria-label='Breast tenderness, cysts' aria-invalid='false' aria-required=false> <span>Breast tenderness, cysts<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=current_symptoms_e7a6cadea3087ae042720dc343c46747><input  type=\"checkbox\" name=\"current_symptoms[]\" data-name=\"current_symptoms\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Hot flashes, night sweats \" data-calc_value=\"2\"  id='current_symptoms_e7a6cadea3087ae042720dc343c46747' aria-label='Hot flashes, night sweats ' aria-invalid='false' aria-required=false> <span>Hot flashes, night sweats <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=current_symptoms_ee29be4370d9995e9d963c32e368cf81><input  type=\"checkbox\" name=\"current_symptoms[]\" data-name=\"current_symptoms\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Vaginal dryness \" data-calc_value=\"2\"  id='current_symptoms_ee29be4370d9995e9d963c32e368cf81' aria-label='Vaginal dryness ' aria-invalid='false' aria-required=false> <span>Vaginal dryness <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=current_symptoms_6be50ad10f2e210a4c92f703db26ee34><input  type=\"checkbox\" name=\"current_symptoms[]\" data-name=\"current_symptoms\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Frequent UTls\" data-calc_value=\"2\"  id='current_symptoms_6be50ad10f2e210a4c92f703db26ee34' aria-label='Frequent UTls' aria-invalid='false' aria-required=false> <span>Frequent UTls<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=current_symptoms_042f0cbc437f476ddf35cabf35ad774b><input  type=\"checkbox\" name=\"current_symptoms[]\" data-name=\"current_symptoms\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Frequent thirst, frequent urination\" data-calc_value=\"8\"  id='current_symptoms_042f0cbc437f476ddf35cabf35ad774b' aria-label='Frequent thirst, frequent urination' aria-invalid='false' aria-required=false> <span>Frequent thirst, frequent urination<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=current_symptoms_bd9853bcc365ed12bedda45138a8961a><input  type=\"checkbox\" name=\"current_symptoms[]\" data-name=\"current_symptoms\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Joint aches or pains \" data-calc_value=\"2\"  id='current_symptoms_bd9853bcc365ed12bedda45138a8961a' aria-label='Joint aches or pains ' aria-invalid='false' aria-required=false> <span>Joint aches or pains <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=current_symptoms_7fa5ff1b2e08a7889eb177c6be3b7503><input  type=\"checkbox\" name=\"current_symptoms[]\" data-name=\"current_symptoms\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Symptoms of excess estrogen (weight gain, depression, heavy periods, low libido, breast tenderness, fibrocystic breasts, fibroids, gallbladder problems)\" data-calc_value=\"3\"  id='current_symptoms_7fa5ff1b2e08a7889eb177c6be3b7503' aria-label='Symptoms of excess estrogen (weight gain, depression, heavy periods, low libido, breast tenderness, fibrocystic breasts, fibroids, gallbladder problems)' aria-invalid='false' aria-required=false> <span>Symptoms of excess estrogen (weight gain, depression, heavy periods, low libido, breast tenderness, fibrocystic breasts, fibroids, gallbladder problems)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=current_symptoms_20f450624bd8cd9790f7ae6784d42090><input  type=\"checkbox\" name=\"current_symptoms[]\" data-name=\"current_symptoms\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Loss of bone density (osteopenia, osteoporosis, loss of height) \" data-calc_value=\"6\"  id='current_symptoms_20f450624bd8cd9790f7ae6784d42090' aria-label='Loss of bone density (osteopenia, osteoporosis, loss of height) ' aria-invalid='false' aria-required=false> <span>Loss of bone density (osteopenia, osteoporosis, loss of height) <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=current_symptoms_2edace43473df6985f7f33a8a25c7c50><input  type=\"checkbox\" name=\"current_symptoms[]\" data-name=\"current_symptoms\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Muscle weakness or loss of muscle\" data-calc_value=\"5\"  id='current_symptoms_2edace43473df6985f7f33a8a25c7c50' aria-label='Muscle weakness or loss of muscle' aria-invalid='false' aria-required=false> <span>Muscle weakness or loss of muscle<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=current_symptoms_b37d2d2e9ffba0d47c23c23d19b34af2><input  type=\"checkbox\" name=\"current_symptoms[]\" data-name=\"current_symptoms\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Frequent colds or illnesses\" data-calc_value=\"6\"  id='current_symptoms_b37d2d2e9ffba0d47c23c23d19b34af2' aria-label='Frequent colds or illnesses' aria-invalid='false' aria-required=false> <span>Frequent colds or illnesses<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=current_symptoms_5b8e3f799145c4466e3129f6d1f66311><input  type=\"checkbox\" name=\"current_symptoms[]\" data-name=\"current_symptoms\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Sluggish bowels, constipation \" data-calc_value=\"7\"  id='current_symptoms_5b8e3f799145c4466e3129f6d1f66311' aria-label='Sluggish bowels, constipation ' aria-invalid='false' aria-required=false> <span>Sluggish bowels, constipation <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=current_symptoms_57ab75035ef842ec667891ac4b1c27ea><input  type=\"checkbox\" name=\"current_symptoms[]\" data-name=\"current_symptoms\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Feeling cold all the time, have to wear a sweater even if nobody else is, low body temperature\" data-calc_value=\"7\"  id='current_symptoms_57ab75035ef842ec667891ac4b1c27ea' aria-label='Feeling cold all the time, have to wear a sweater even if nobody else is, low body temperature' aria-invalid='false' aria-required=false> <span>Feeling cold all the time, have to wear a sweater even if nobody else is, low body temperature<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=current_symptoms_c0906ae4a290fb74056caaacf7dc271e><input  type=\"checkbox\" name=\"current_symptoms[]\" data-name=\"current_symptoms\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"High blood sugar \" data-calc_value=\"8\"  id='current_symptoms_c0906ae4a290fb74056caaacf7dc271e' aria-label='High blood sugar ' aria-invalid='false' aria-required=false> <span>High blood sugar <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=current_symptoms_57ece283bb15e66875a2420ae35d02b6><input  type=\"checkbox\" name=\"current_symptoms[]\" data-name=\"current_symptoms\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"High blood pressure (&gt;130\/80) \" data-calc_value=\"8\"  id='current_symptoms_57ece283bb15e66875a2420ae35d02b6' aria-label='High blood pressure (&gt;130\/80) ' aria-invalid='false' aria-required=false> <span>High blood pressure (>130\/80) <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=current_symptoms_c6948c2896d02fabd3524d76a47cc4ec><input  type=\"checkbox\" name=\"current_symptoms[]\" data-name=\"current_symptoms\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"None of the above\" data-calc_value=\"0\"  id='current_symptoms_c6948c2896d02fabd3524d76a47cc4ec' aria-label='None of the above' aria-invalid='false' aria-required=false> <span>None of the above<\/span><\/label><\/div><\/div><\/div><div class='step-nav ff_step_nav_last'><button tabindex='22'  type='button' data-action='prev' class='ff-btn ff-btn-prev ff-btn-secondary'>Previous<\/button><button tabindex='23'  type='button' data-action='next' class='ff-float-right ff-btn ff-btn-next ff-btn-secondary'>Next<\/button><\/div><\/div><div class=\" fluentform-step\" data-name=\"form_step-7_9\" ><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  aria-label=\"Any history of any of the following?\">Any history of any of the following?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=history_7da648e3f628c4a2b44210c3a26cc267><input  type=\"checkbox\" name=\"history[]\" data-name=\"history\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"24\" value=\"Uterine fibroids\" data-calc_value=\"1\"  id='history_7da648e3f628c4a2b44210c3a26cc267' aria-label='Uterine fibroids' aria-invalid='false' aria-required=false> <span>Uterine fibroids<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=history_ea98db8cc9301024fc5d592d3e0ef146><input  type=\"checkbox\" name=\"history[]\" data-name=\"history\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Endometriosis\" data-calc_value=\"3\"  id='history_ea98db8cc9301024fc5d592d3e0ef146' aria-label='Endometriosis' aria-invalid='false' aria-required=false> <span>Endometriosis<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=history_e6aee3395878ae5d085a5c87dc92eab5><input  type=\"checkbox\" name=\"history[]\" data-name=\"history\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Gallbladder problems\" data-calc_value=\"1\"  id='history_e6aee3395878ae5d085a5c87dc92eab5' aria-label='Gallbladder problems' aria-invalid='false' aria-required=false> <span>Gallbladder problems<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=history_b9793c04bd3f3f73d0740c426970d674><input  type=\"checkbox\" name=\"history[]\" data-name=\"history\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Using estrogen-containing birth control or medication (in the last three months)\" data-calc_value=\"1\"  id='history_b9793c04bd3f3f73d0740c426970d674' aria-label='Using estrogen-containing birth control or medication (in the last three months)' aria-invalid='false' aria-required=false> <span>Using estrogen-containing birth control or medication (in the last three months)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=history_d334d80deabd302c8d6fc2cd2fb7a301><input  type=\"checkbox\" name=\"history[]\" data-name=\"history\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Autoimmune disease\" data-calc_value=\"6\"  id='history_d334d80deabd302c8d6fc2cd2fb7a301' aria-label='Autoimmune disease' aria-invalid='false' aria-required=false> <span>Autoimmune disease<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=history_67dcbe2c98e3fccdcf85f747ef986ad7><input  type=\"checkbox\" name=\"history[]\" data-name=\"history\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Fertility problems\" data-calc_value=\"3\"  id='history_67dcbe2c98e3fccdcf85f747ef986ad7' aria-label='Fertility problems' aria-invalid='false' aria-required=false> <span>Fertility problems<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=history_dc09d2374b567d48954671e6009a3ecd><input  type=\"checkbox\" name=\"history[]\" data-name=\"history\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Recurrent miscarriage\" data-calc_value=\"3\"  id='history_dc09d2374b567d48954671e6009a3ecd' aria-label='Recurrent miscarriage' aria-invalid='false' aria-required=false> <span>Recurrent miscarriage<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=history_dd6523f4f578f8a6b0623db25a0c65b4><input  type=\"checkbox\" name=\"history[]\" data-name=\"history\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Fertility challenges\" data-calc_value=\"4\"  id='history_dd6523f4f578f8a6b0623db25a0c65b4' aria-label='Fertility challenges' aria-invalid='false' aria-required=false> <span>Fertility challenges<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=history_fed258d9dc90ac164b4971d0f9df29c1><input  type=\"checkbox\" name=\"history[]\" data-name=\"history\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Polycystic ovary syndrome (PCOS)\" data-calc_value=\"8\"  id='history_fed258d9dc90ac164b4971d0f9df29c1' aria-label='Polycystic ovary syndrome (PCOS)' aria-invalid='false' aria-required=false> <span>Polycystic ovary syndrome (PCOS)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=history_08dbb024c1823e29a55a474bd319fc16><input  type=\"checkbox\" name=\"history[]\" data-name=\"history\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"High cholesterol\" data-calc_value=\"7\"  id='history_08dbb024c1823e29a55a474bd319fc16' aria-label='High cholesterol' aria-invalid='false' aria-required=false> <span>High cholesterol<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=history_982c7112d93e3b8b106002aae36a7917><input  type=\"checkbox\" name=\"history[]\" data-name=\"history\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Trouble getting pregnant, history of miscarriage\" data-calc_value=\"7\"  id='history_982c7112d93e3b8b106002aae36a7917' aria-label='Trouble getting pregnant, history of miscarriage' aria-invalid='false' aria-required=false> <span>Trouble getting pregnant, history of miscarriage<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=history_12b3485ef7ee89ce8f4ba9909283d8d4><input  type=\"checkbox\" name=\"history[]\" data-name=\"history\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"History of postpartum depression or trouble producing breast milk\" data-calc_value=\"7\"  id='history_12b3485ef7ee89ce8f4ba9909283d8d4' aria-label='History of postpartum depression or trouble producing breast milk' aria-invalid='false' aria-required=false> <span>History of postpartum depression or trouble producing breast milk<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=history_0e3ff71231286d7d04255dbca4cc22b6><input  type=\"checkbox\" name=\"history[]\" data-name=\"history\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Metabolic syndrome, insulin resistance, or diabetes \" data-calc_value=\"8\"  id='history_0e3ff71231286d7d04255dbca4cc22b6' aria-label='Metabolic syndrome, insulin resistance, or diabetes ' aria-invalid='false' aria-required=false> <span>Metabolic syndrome, insulin resistance, or diabetes <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=history_874d6d1130ab8731fd72ff117f2b0d8b><input  type=\"checkbox\" name=\"history[]\" data-name=\"history\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Gestational diabetes or had a baby who weighed more than 9 pounds\" data-calc_value=\"8\"  id='history_874d6d1130ab8731fd72ff117f2b0d8b' aria-label='Gestational diabetes or had a baby who weighed more than 9 pounds' aria-invalid='false' aria-required=false> <span>Gestational diabetes or had a baby who weighed more than 9 pounds<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=history_7514a5e00b80b26278ace575ba5586fb><input  type=\"checkbox\" name=\"history[]\" data-name=\"history\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"None of the above\" data-calc_value=\"0\"  id='history_7514a5e00b80b26278ace575ba5586fb' aria-label='None of the above' aria-invalid='false' aria-required=false> <span>None of the above<\/span><\/label><\/div><\/div><\/div><div class='step-nav ff_step_nav_last'><button tabindex='25'  type='button' data-action='prev' class='ff-btn ff-btn-prev ff-btn-secondary'>Previous<\/button><button tabindex='26'  type='button' data-action='next' class='ff-float-right ff-btn ff-btn-next ff-btn-secondary'>Next<\/button><\/div><\/div><div class=\" fluentform-step\" data-name=\"form_step-7_10\" ><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  aria-label=\"When it comes to food, body, and weight, are you experiencing...\">When it comes to food, body, and weight, are you experiencing&#8230;<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=food_6b5b9fac15a9fbd53a08d2b083c04669><input  type=\"checkbox\" name=\"food[]\" data-name=\"food\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"27\" value=\"Craving sweets, chocolate, or salty foods \" data-calc_value=\"6\"  id='food_6b5b9fac15a9fbd53a08d2b083c04669' aria-label='Craving sweets, chocolate, or salty foods ' aria-invalid='false' aria-required=false> <span>Craving sweets, chocolate, or salty foods <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=food_be4d774432c6a8c7683ab6ac9dbf56f6><input  type=\"checkbox\" name=\"food[]\" data-name=\"food\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Shakiness or agitation between meals \" data-calc_value=\"8\"  id='food_be4d774432c6a8c7683ab6ac9dbf56f6' aria-label='Shakiness or agitation between meals ' aria-invalid='false' aria-required=false> <span>Shakiness or agitation between meals <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=food_38d9cfde7f729442261dfefa096f2fd1><input  type=\"checkbox\" name=\"food[]\" data-name=\"food\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Waist circumference &gt;30 inches \" data-calc_value=\"8\"  id='food_38d9cfde7f729442261dfefa096f2fd1' aria-label='Waist circumference &gt;30 inches ' aria-invalid='false' aria-required=false> <span>Waist circumference >30 inches <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=food_06eafc4050b90bb62a566a38cdb007bc><input  type=\"checkbox\" name=\"food[]\" data-name=\"food\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"A pear-shaped body\" data-calc_value=\"1\"  id='food_06eafc4050b90bb62a566a38cdb007bc' aria-label='A pear-shaped body' aria-invalid='false' aria-required=false> <span>A pear-shaped body<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=food_9f1c9c65ac61662ed38d82d410814c53><input  type=\"checkbox\" name=\"food[]\" data-name=\"food\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Weight gain\" data-calc_value=\"5\"  id='food_9f1c9c65ac61662ed38d82d410814c53' aria-label='Weight gain' aria-invalid='false' aria-required=false> <span>Weight gain<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=food_5787b6fd6274016c18acea8ae5fb8ffd><input  type=\"checkbox\" name=\"food[]\" data-name=\"food\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Weight gain without changing eating or exercise habits \" data-calc_value=\"7\"  id='food_5787b6fd6274016c18acea8ae5fb8ffd' aria-label='Weight gain without changing eating or exercise habits ' aria-invalid='false' aria-required=false> <span>Weight gain without changing eating or exercise habits <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=food_21d1270374a2399220dfa3e7f00542b6><input  type=\"checkbox\" name=\"food[]\" data-name=\"food\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Trouble losing weight, despite dieting and exercise \" data-calc_value=\"7\"  id='food_21d1270374a2399220dfa3e7f00542b6' aria-label='Trouble losing weight, despite dieting and exercise ' aria-invalid='false' aria-required=false> <span>Trouble losing weight, despite dieting and exercise <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=food_782369f14e257fd10e1d1c309427a676><input  type=\"checkbox\" name=\"food[]\" data-name=\"food\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Overweight, especially around my middle (&quot;muffin top&quot;)\" data-calc_value=\"8\"  id='food_782369f14e257fd10e1d1c309427a676' aria-label='Overweight, especially around my middle (&quot;muffin top&quot;)' aria-invalid='false' aria-required=false> <span>Overweight, especially around my middle (&#8220;muffin top&#8221;)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=food_af2edd8e04a332a5aa8585ea5d7987e1><input  type=\"checkbox\" name=\"food[]\" data-name=\"food\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"None of the above\" data-calc_value=\"0\"  id='food_af2edd8e04a332a5aa8585ea5d7987e1' aria-label='None of the above' aria-invalid='false' aria-required=false> <span>None of the above<\/span><\/label><\/div><\/div><\/div><div class='step-nav ff_step_nav_last'><button tabindex='28'  type='button' data-action='prev' class='ff-btn ff-btn-prev ff-btn-secondary'>Previous<\/button><button tabindex='29'  type='button' data-action='next' class='ff-float-right ff-btn ff-btn-next ff-btn-secondary'>Next<\/button><\/div><\/div><div class=\" fluentform-step\" data-name=\"form_step-7_11\" ><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  aria-label=\"And when it comes to your hair, skin, and nails, do any of the following apply?\">And when it comes to your hair, skin, and nails, do any of the following apply?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=hair_53739f0617be26f4d4ffe0a95827e572><input  type=\"checkbox\" name=\"hair[]\" data-name=\"hair\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"30\" value=\"Varicose veins\" data-calc_value=\"1\"  id='hair_53739f0617be26f4d4ffe0a95827e572' aria-label='Varicose veins' aria-invalid='false' aria-required=false> <span>Varicose veins<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=hair_d96ca051e65ee6de16f7fff74e2b48d2><input  type=\"checkbox\" name=\"hair[]\" data-name=\"hair\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Hair in unwanted places\" data-calc_value=\"8\"  id='hair_d96ca051e65ee6de16f7fff74e2b48d2' aria-label='Hair in unwanted places' aria-invalid='false' aria-required=false> <span>Hair in unwanted places<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=hair_e67b95c18911458b5b2c59b9bb92ca3c><input  type=\"checkbox\" name=\"hair[]\" data-name=\"hair\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Hair loss, hair thinning \" data-calc_value=\"8\"  id='hair_e67b95c18911458b5b2c59b9bb92ca3c' aria-label='Hair loss, hair thinning ' aria-invalid='false' aria-required=false> <span>Hair loss, hair thinning <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=hair_a8807292c8d14c39a0f637735961a138><input  type=\"checkbox\" name=\"hair[]\" data-name=\"hair\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Acne\" data-calc_value=\"4\"  id='hair_a8807292c8d14c39a0f637735961a138' aria-label='Acne' aria-invalid='false' aria-required=false> <span>Acne<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=hair_2ba6e1b97436e9b02776ea9d84d68c85><input  type=\"checkbox\" name=\"hair[]\" data-name=\"hair\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Increased skin wrinkling for your age\" data-calc_value=\"6\"  id='hair_2ba6e1b97436e9b02776ea9d84d68c85' aria-label='Increased skin wrinkling for your age' aria-invalid='false' aria-required=false> <span>Increased skin wrinkling for your age<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=hair_d1d41863092fd852900ba81533c8f4f0><input  type=\"checkbox\" name=\"hair[]\" data-name=\"hair\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Dry, itchy, or rough skin \" data-calc_value=\"7\"  id='hair_d1d41863092fd852900ba81533c8f4f0' aria-label='Dry, itchy, or rough skin ' aria-invalid='false' aria-required=false> <span>Dry, itchy, or rough skin <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=hair_63644d95410086d741c49a6b9929373d><input  type=\"checkbox\" name=\"hair[]\" data-name=\"hair\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Brittle or coarse hair or nails \" data-calc_value=\"7\"  id='hair_63644d95410086d741c49a6b9929373d' aria-label='Brittle or coarse hair or nails ' aria-invalid='false' aria-required=false> <span>Brittle or coarse hair or nails <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=hair_a42dc8afa4c005925bd628a82bb20c35><input  type=\"checkbox\" name=\"hair[]\" data-name=\"hair\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Puffiness around eyes, face gets puffy \" data-calc_value=\"7\"  id='hair_a42dc8afa4c005925bd628a82bb20c35' aria-label='Puffiness around eyes, face gets puffy ' aria-invalid='false' aria-required=false> <span>Puffiness around eyes, face gets puffy <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=hair_8fb29b4b10d1f966330389e002cc3fd9><input  type=\"checkbox\" name=\"hair[]\" data-name=\"hair\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Loss or thinning of outer third of eyebrows \" data-calc_value=\"7\"  id='hair_8fb29b4b10d1f966330389e002cc3fd9' aria-label='Loss or thinning of outer third of eyebrows ' aria-invalid='false' aria-required=false> <span>Loss or thinning of outer third of eyebrows <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=hair_c4e73f12bf6455e190a430232d1abe43><input  type=\"checkbox\" name=\"hair[]\" data-name=\"hair\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Skin tags \" data-calc_value=\"8\"  id='hair_c4e73f12bf6455e190a430232d1abe43' aria-label='Skin tags ' aria-invalid='false' aria-required=false> <span>Skin tags <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=hair_b7407de0e0b6d840ae214582d544ed0c><input  type=\"checkbox\" name=\"hair[]\" data-name=\"hair\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Brown, velvety skin discoloration in my armpits, groin, or neck \" data-calc_value=\"8\"  id='hair_b7407de0e0b6d840ae214582d544ed0c' aria-label='Brown, velvety skin discoloration in my armpits, groin, or neck ' aria-invalid='false' aria-required=false> <span>Brown, velvety skin discoloration in my armpits, groin, or neck <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=hair_9e61b84130e234d59039d11bec9b3097><input  type=\"checkbox\" name=\"hair[]\" data-name=\"hair\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" tabindex=\"-1\" value=\"Acne, especially cystic acne\" data-calc_value=\"8\"  id='hair_9e61b84130e234d59039d11bec9b3097' aria-label='Acne, especially cystic acne' aria-invalid='false' aria-required=false> <span>Acne, especially cystic acne<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' 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