Document K6bDrXYBG34O6Y1gon7D83r66
Study ID Number _ _ _ __
Name _ _ __
I Other
MHH 2 What is the longest time (duration) that you took herbs in your life? [J less than a week [J a week to a month [J a month to a year [J more than a year [J do not know
MHH 3 When did you last take the herbs [J taking now [J less than one month ago [J about one month to one year ago ? [J more than a year ago [J do not know
Version 24 February 2004 CC_DP Questionnaire
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SH ELL-MCCLU RG-059285