fbpx

Client Cellular-Level Evaluation

    Please select your desired cellular-levels goals:

    Digestive balance/comfortLower cholesterolWeight lossWeight gainIncreased energy

    Select all that apply to you or your family:

    DiabetesFood intolerancesHigh cholesterolHigh blood pressureBlood clottingObesityFibrosisAuto-immune diseaseArthritisRecent injury/surgeryChronic painOsteoporosisAnemiaCancerRadiation exposure

    Select all medications that apply to you:

    AntacidsLaxativesUlcer medAntibioticBlood thinnerHeart medBlood-pressureCortisoneAnti-inflammatoryOral contraceptiveHormone medRelaxant/sleeping pillThyroid medAnti-depressant

    Select consumption (0 – never, 3 – sometimes, 5 – daily):









    Select any cellular-level issues you may be experiencing:

    Bloating/indigestion/gasConstipationDiarrheaOver-eatingSweets/sugar cravingsTiredness/fatiguePoor circulationFailing visionJoint pain/grinding/swellingEasy bruisingSlow recovery after you get sickMuscle crampsLight-headedness/headachesUrinary-tract painYellow discoloration in eyesAge spotsLack of concentration (brain fog)Irritability/anxietyHigh-stressBack pain near kidneysHeavy menstrual bleedingMonthly crampsFrequent colds/flu-like symptoms/infections