Medications
Please list any medications you are taking as well as the reason you are taking them.
Supplements
Please list any supplements you are taking as well as the reason you are taking them.
Health Concerns
Please list your top 5 health concerns.
What are the 3 worst foods you eat during the average week?
What are the 3 healthiest foods you eat during the average week?
Group One
Please indicate the symptoms that you have experienced within the last three month by selecting the appropriate number as these symptoms apply to you:
1 = Never, rare or mild 2 = Moderate or frequent 3 = Severe or constant.
Group Two
Group Three
Group Four