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GI-MAP Screening
Questions
First name
*
Last name
*
Email
*
Do you frequently experience bloating, especially after meals?
*
Yes
No
Sometimes
Do you have constipation (less than one bowel movement per day) or loose stools/diarrhea regularly?
*
Do you notice undigested food, mucus, or oily residue in your stool?
*
Yes
No
Sometimes
Do you suffer from chronic gas, belching, or abdominal discomfort?
*
Yes, often
Yes, occassionally
Rarely
Never
Have you ever had food poisoning, traveler's diarrhea, or taken antibiotics in the past 5 years?
*
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