PLEASE CHECK THE BOX IF YOU HAVE HAD THE SURGERY.

    APPENDECTOMY
    BACK SURGERY
    NECK SURGERY
    CABG
    REMOVAL OF GALLBLADDER
    FOOT SURGERY
    HYSTERECTOMY
    TONSILLECTOMY
    TUBAL LIGATION
    HEART SURGERY
    CARDIAC STENT PLACEMENT
    THYROID SURGERY
    OTHER