Do You Use Alternative Medicine
for Menopause Symptoms and Concerns ?
YOUR ANSWERS ARE CONFIDENTIAL AND WILL NOT BE SHARED WITH ANY ONE ELSE

Have You Had Menopausal Symptoms or Concerns Within the Past Year? If So, Please Take Our Survey.
What Are You Doing For Your Symptoms or Concerns? Hormone Therapy Alternative Therapy Both Therapies Neither Therapy
If You Have Used Alternative Therapy, or Both Therapies Please Select From The Following List of Symptoms or Concerns. Choose the Alternative Treatments you Have Used.
SYMPTOMS:
Hot Flashes Yes No	Select Treatments: Herbs Calcium Vitamin/supplement other than Calcium Proper nutrition/Diet	Exercise Acupuncture Relaxation/Meditation Homeopathy
Period Changes Yes No	Select Treatments: Herbs Calcium Vitamin/supplement other than Calcium Proper nutrition/Diet	Exercise Acupuncture Relaxation/Meditation Homeopathy
Anxiety Yes No	Select Treatments: Herbs Calcium Vitamin/supplement other than Calcium Proper nutrition/Diet	Exercise Acupuncture Relaxation/Meditation Homeopathy
Fatigue Yes No	Select Treatments: Herbs Calcium Vitamin/supplement other than Calcium Proper nutrition/Diet	Exercise Acupuncture Relaxation/Meditation Homeopathy
Mood Swings Yes No	Select Treatments: Herbs Calcium Vitamin/supplement other than Calcium Proper nutrition/Diet	Exercise Acupuncture Relaxation/Meditation Homeopathy
Forgetfulness Yes No	Select Treatments: Herbs Calcium Vitamin/supplement other than Calcium Proper nutrition/Diet	Exercise Acupuncture Relaxation/Meditation Homeopathy
Insomnia Yes No	Select Treatments: Herbs Calcium Vitamin/supplement other than Calcium Proper nutrition/Diet	Exercise Acupuncture Relaxation/Meditation Homeopathy
Weight Gain Yes No	Select Treatments: Herbs Calcium Vitamin/supplement other than Calcium Proper nutrition/Diet	Exercise Acupuncture Relaxation/Meditation Homeopathy
Vaginal Dryness Yes No	Select Treatments: Herbs Calcium Vitamin/supplement other than Calcium Proper nutrition/Diet	Exercise Acupuncture Relaxation/Meditation Homeopathy
Headache Yes No	Select Treatments: Herbs Calcium Vitamin/supplement other than Calcium Proper nutrition/Diet	Exercise Acupuncture Relaxation/Meditation Homeopathy
Night Sweats Yes No	Select Treatments: Herbs Calcium Vitamin/supplement other than Calcium Proper nutrition/Diet	Exercise Acupuncture Relaxation/Meditation Homeopathy
Depression Yes No	Select Treatments: Herbs Calcium Vitamin/supplement other than Calcium Proper nutrition/Diet	Exercise Acupuncture Relaxation/Meditation Homeopathy
CONCERNS:
Osteoporosis Yes No	Select Treatments: Herbs Calcium Vitamin/supplement other than Calcium Proper nutrition/Diet	Exercise Acupuncture Relaxation/Meditation Homeopathy
Heart Disease Yes No	Select Treatments: Herbs Calcium Vitamin/supplement other than Calcium Proper nutrition/Diet	Exercise Acupuncture Relaxation/Meditation Homeopathy
ADDITIONAL COMMENTS ?

DEMOGRAPHICS:
Age		Race
Education		Household Income
State/Country

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Do You Use Alternative Medicine for Menopause Symptoms and Concerns ? YOUR ANSWERS ARE CONFIDENTIAL AND WILL NOT BE SHARED WITH ANY ONE ELSE

Do You Use Alternative Medicine
for Menopause Symptoms and Concerns ?
YOUR ANSWERS ARE CONFIDENTIAL AND WILL NOT BE SHARED WITH ANY ONE ELSE