Lifelines Questionnaire 1 part 1
1. Do you have allergies?
2. General Questions:
2.a) What is your gender?
2.b) What is your date of birth?
2.c) What is your country of birth?
2.d) What is your marital status?
3. Intoxications:
3.a) Do you smoke?
3.b) Do you drink alcohol?