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DUTCH Program Survey - Month 4

This is a check in survey, so we can see how you are doing and how we can best support you in this program! 

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Question 1 of 5

Please list 3 of your primary symptoms. On a scale of 1-10 (1 being the lowest, and 10 being the highest) please rate your overall improvement with those 3 symptoms thus far:

Question 2 of 5

What have you achieved so far in this program? 

Question 3 of 5

What are you still hoping to achieve?

Question 4 of 5

What (if any) are your biggest hang ups with following your current protocol? 

Question 5 of 5

Is there anything that you feel you need more information on?

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