| 1.) I feel anxious | | | | | |
| 2.) I feel like yawning | | | | | |
| 3.) I am perspiring | | | | | |
| 4.) My eyes are teary | | | | | |
| 5.) My nose is running | | | | | |
| 6.) I have goosebumps | | | | | |
| 7.) I am shaking | | | | | |
| 8.) I have hot flashes | | | | | |
| 9.) I have cold flashes | | | | | |
| 10.) My bones and muscles ache | | | | | |
| 11.) I feel restless | | | | | |
| 12.) I feel nauseous | | | | | |
| 13.) I feel like vomiting | | | | | |
| 14.) My muscles twitch | | | | | |
| 15.) I have stomach cramps | | | | | |
| 16.) I feel like using now | | | | | |
