4. what is the cause of my constipation?
5. why can i not sleep?
6. what are the symptoms of my illness/disease? (four to six symptoms) This should be stated in terms that you would expect your doctor to state them, such as “I suffer from a severe allergy which results in hives and swelling.” Or: “I have been plagued with insomnia for many years because I am worried about getting cancer.”
7. what does this ailment do to me physically; emotionally; spiritually? What happens if I don’t take care of it and how long could it last without treatment (the sooner you deal with it, the quicker you will get better)?
8. how many times has this happened recently and when did each episode occur last time? Details must be given here; e.g., “My sores come out during an attack or at night after five minutes.” It may help if you note dates on your chart as well as other details such as degrees of severity or frequency, number involved each time (“three warts on right hand”), duration (“six months”) etc.)
9 .how does this affect me financially now and into the future? How much money would I lose were I unable to work until fully recovered by any means necessary including taking disability payments/filing for Social Security Disability benefits?”10 .what else can we do besides medical treatment(s