Excellent 4.9
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Do you have any of the following medical conditions?
Please check all that apply.
Asthma
Heart attack / heart failure
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Kidney disease / kidney failure
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Liver disease / Liver failure
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Retinitis pigmentosa or anterior ischemic optic neuropathy
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Severe aortic stenosis OR Hypertrophic obstructive cardiomyopathy (HOCM)
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Pulmonary Hypertension
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Uncontrolled high blood pressure (hypertension)
Low blood pressure (hypotension)
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Sickle cell anemia, myeloma, or leukemia
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Multiple sclerosis (MS) or similar disease, spinal injuries or paralysis
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Irregular heartbeat (arrhythmias, atrial fibrillation, etc.)
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Chest pain (angina)
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Prolongation of QT interval
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Peripheral vascular disease
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Coronary artery disease
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Fainting episodes
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Stroke
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Heart failure
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None of the above
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