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    <p>
        <b>B-Lymphoproliferative Disorders Symptom Questionnaire</b>
    </p>
    
    <p>
        <u>Symptoms which can be associated with disease activity:</u>
    </p>
    
    <p>
        <i>
            Enlarged lymph nodes: swelling of nodes/glands that lasts for more
            than 2 weeks. Common areas where the lymph nodes are located and can
            be felt include the groin, armpit, down each side of the neck, under
            the jaw and chin, behind the ears or on the back of the head.        
        </i>
    </p>
    
	<p>
        Do you have any swollen nodes/glands   YES [ ]   NO [ ]
	</p>
    
    <p align="right">
        If yes, is the swelling: Long-standing but stable [ ]   
        New, or  long-standing but getting worse [ ]
    </p>
    
    <p align="right">
        If yes, is the swelling in the: Neck [ ]    Armpits [ ]    Abdomen [ ]   
        Groin [ ]
    </p>
    
    <p>
        <i>
            Night Sweats: significant night time sweating that soaks the bed
            clothes and bedding.
        </i>
    </p>
    
    <p>
        Do you have night sweats:    No [ ]    Occasionally [ ]    Often [ ]   
        Often, drenching sweats [ ]
    </p>

    <p>
        If you develop one of these symptoms, or a pre-existing symptom becomes
        significantly worse, please contact us (details above)
    </p>

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