I need you to create a screening form , make at least 10-11 questions. I added

I need you to create a screening form , make at least 10-11 questions.
I added all assignment details and instructions.
Please make sure you apply every criteria in the rubric
I need questions to be about ( hematologic, cardiovascular, pulmonary, endocrine/metabolic, immune, hepatic, GI, biliary, urogenital, and cancer).
Please make sure that it’s made from scratch!
Thank you!