HLQ Data: CMMI_HA_010

Participant Information

CMMI ID:
CMMI_HA_010

Study ID:
MMS000061

Questionnaire Date:
2025-12-04 08:38

Upload:
Manual Import

Age:
66

Sex:
Male

Lives Alone:
Yes

General Health:
Fair

Takes Supplements:
Yes (2)

Demographics & Household3
Sex
1
Age Calc
66
Live Alone
1
Pets1
Pets Hh
0
General Health & Supplements9
Amemia
0
Gluten
2
Behav Chg
0
Gen Health
2
Food Allergies
1
Reg Supplement
1
Food Allergies Sp
WHITE FISH, PERHAPS OTHER SENSITIVITIES
Reg Supplement Sp
NEW ROOTS PROBIOTIC INTENSITY
Reg Supplement Num
2
Bowel Habits & Digestion17
Bowel 1
0
Bowel 2
0
Bowel 3
0
Bowel 4
0
Bowel 6
0
Bowel 7
1
Bowel 8
1
Bowel 9
2
Stool 1
0
Stool 2
0
Stool 3
0
Stool 4
2
Stool 5
0
Stool 6
0
Bloating
1
Laxatives
0
Constipation Symp 6 Mo
0
IBS Symptoms3
Pain Abs 3 Mos
0
Pain Abs 6 Mos
0
Pain Abs Menstru
3
Health-Related Medications3
Med Acid Reflux
0
Med Antibiotics
0
Med Constipation
0
Current Medications10
Med 1
TRAZODONE
Med 2
LIOTHYRONINE
Med 3
VYVANSE
Med 4
METFORMIN
Med Num
4
Med Type 1
ANTIDEPRESSANT BUT BEING USED FOR PERIODIC LIMB MOVEMENT DISORDER
Med Type 2
THYROID
Med Type 3
STIMULANT
Med Type 4
DIABETES
Med Current
1
Disease History - Cardiovascular11
Hf Ever
0
Mi Ever
0
Chd Ever
0
Hbp Ever
0
Vhd Ever
0
Angina Ever
0
Atrial Ever
0
Cardio Ever
0
Thrombo Ever
0
High Chol Ever
0
Arrhythmia Ever
0
Disease History - Diabetes4
Diab Ever
1
Diab Gest
0
Diab Type1
0
Diab Type2
1
Disease History - Respiratory7
Cb Ever
0
Ild Ever
0
Copd Ever
0
Resp Ever
1
Asthma Ever
1
Emphysema Ever
0
Cystic Fib Ever
0
Disease History - Digestive & GI10
Lc Ever
0
Uc Ever
0
Ibs Ever
0
Gerd Ever
0
Crohn Ever
0
Fatty Ever
0
Celiac Ever
0
Gastro Ever
0
Ulcers Ever
0
Gallstones Ever
0
Disease History - Neurological5
Ms Ever
0
Neuro Ever
0
Dement Ever
0
Migraine Ever
0
Alzheimer Ever
0
Disease History - Autoimmune & Inflammatory11
Sle Ever
0
Arthritis Ever
1
Fibromyal Ever
0
Scleroderma Ever
0
Weak Immune Ever
0
Arthritis Oa Ever
1
Arthritis Ra Ever
0
Arthritis Other Ever
0
Sjogren Syndrome Ever
0
Hashimoto Thyroid Ever
0
Ankylosing Spondylitis Ever
0
Disease History - Bone & Muscle3
Op Ever
0
Rd Ever
0
Bones Ever
1
Disease History - Skin4
Ps Ever
0
Skin Ever
0
Eczema Ever
0
Rosacea Ever
0
Disease History - Kidney & Liver5
Hemo Ever
0
Liver Ever
0
Acute Fail Ever
0
Chronic Fail Ever
0
Kidney Stones Ever
0
Disease History - Other Conditions7
Ch Ever
0
Hm Ever
0
Hiv Ever
0
Infec Ever
0
Other Cond Ever
0
Infec Type Other
0
Sleep Apnea Ever
1
Mental Health - Depression & Anxiety22
Mh Ever
1
Dep Ever
1
Minor Dep Ever
0
Mh 5 Eating Prob
3
Anxiety Dis Ever
1
Mh 5 Too Restless
0
Mh 3 Sleeping Prob
3
Mh 4 Feeling Tired
2
Mh 6 Easily Annoyed
2
Mh 6 Self Conf Prob
2
Mh 7 Feeling Afraid
1
Mh 8 Impact Anxious
3
Mh 8 Slow Fast Prob
0
Mh 1 Feeling Nervous
1
Mh 1 Little Interest
2
Mh 4 Trouble Relaxing
1
Mh 7 Concentrate Prob
3
Mh 2 Constant Worrying
1
Mh 2 Feeling Depressed
2
Mh 9 Suicidal Thoughts
0
Mh 10 Impact Depressive
3
Mh 3 Excessive Worrying
3
Mental Health - Other Conditions6
Ocd Ever
0
Ptsd Ever
0
Eating Dis Ever
0
Bipolar Dis Ever
0
Schizophrenia Ever
0
Addiction Disorder Ever
0
Sleep - Duration & Quality7
Sleep Hr
6
Awake Time
5:30:00
Sleep Time
22:30:24
Bed Partner
0
Sleep Quality
2
Enthusiam Prob
3
Fall Asleep Time
10
Sleep - Trouble & Disturbances11
Trouble A
0
Trouble B
3
Trouble C
1
Trouble D
1
Trouble E
1
Trouble F
0
Trouble G
0
Trouble H
1
Trouble I
0
Trouble J
3
Trouble Awake Freq
0
Sleep - Medication & Treatment1
Med
3
Physical Activity6
Mod Freq
0
Vig Freq
3
Vig Time
40
Walk Freq
0
Sit Time Wkday
840
Sit Time Wkend
720
Physical Measurements3
Height Ft
5
Height In
8
Weight Lb
270
Smoking & Tobacco2
Ecig 30 Days
0
Cig Cur Freq
0
Drug Use4
Wrk Freq
0
Home Freq
0
Mj Use Cur
0
Illicit Drugs Cur
0
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