Questionnaire 3 – Immune, blood sugar, cardiovascular, muscles, urinary

This form should take you approximately 2 minutes to complete, at the end you will receive a health score assessment identifying key areas that are likley contributing to your health concerns.

Directions

This questionnaire asks you to assess how you have been feeling during the last three months.

For each question, select the number that best describes your symptoms:

0 = No or Rarely - You have never experienced the symptom or the symptom is familiar to you but you experience less than monthly

1 = Occasionally - Symptom comes and goes and is linked in your mind to stress, diet, fatigue or some identifiable trigger

4 = Often - Symptom occurs 2-3 times per week and/or with a frequency that bothers you enough that you would like to do something about it

8 = Frequently - Symptom occurs 4 or more times per week and/or you are aware of the symptom every day, or it occurs with regularity on a monthly or cyclical basis