Checklist of Medical Conditions
| Hypertension | Cancer |
| Myocardial infarct | Migraines |
| Congestive heart failure | Cataracts |
| Stomach trouble | Deafness or trouble hearing |
| Limitation in use of leg or arm | Blurred vision |
| Diabetes | Glaucoma |
| Angina | Macular degeneration |
| Chronic lung disease | Liver trouble |
| Chronic allergies | Epilepsy |
| Seasonal allergies | Sciatica or chronic back problems |
| Arthritis | Trouble seeing |
| Kidney problems | Thyroid problems |
| Dermatitis/other chronic skin rash | Males only: prostate problems |
| Females only: abnormal vaginal bleeding |