Been suspended from school? |
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Served time in a detention center or jail? | |
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Been treated for mental impairment? | |
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Been convicted of a crime? | |
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Been involved with tobacco products? | |
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Been involved with alcohol? | |
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Been involved with illegal drugs? | |
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Been involved with gang-related activities? | |
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Been involved with a cult or the occult? | |
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Had diabetes or hypoglycemia? | |
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Had seizures? | |
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Had fainting spells? | |
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Had an eating disorder? | |
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Had breathing problems? | |
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Had psychiatric care? | |
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Taken depression or behavioral meds? | |
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Been sexaually active? (omit if married) | |
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Been pregnant or fathered a child? | |
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Been involved in homosexual activites? | |
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Attempted suicide? | |
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Been treated for physical impairment? | |
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