Intended for individuals that have been diagnosed with an autoimmune disease, thyroid disease, chronic fatigue syndrome, and/or fibromyalgia.

Please select all situations that apply to you.

As a child, I grew up in an impoverished household.

I was involved in or witness to a horrific accident.

As a child, I was neglected and/or abused.

I have survived a natural disaster and or house fire.

While at work or in the military, l experience a traumatic event.

I have been sexually assaulted.

As a child, I was molested.

I have never experienced any type of abuse, neglect, molestation, sexual assault, or any other type of trauma.

As a child, I grew up in a household where one of my parents was abused by the other.

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