Part I


Part II

Your first step towards better health begins with this simple questionnaire. Please pick the most appropriate number for the next 12 questions.
0 as the least/never, and 3 as the most/always.

Pass large amounts of foul-smelling gas
Frequent bloating after eating
Heartburn or reflux after eating
Alternating constipation and diarrhea
Acne and unhealthy skin
Crave sweets during the day
Irritable, agitated, easily upset
Slow starter most mornings
Tired/sluggish during day
Depression/lack of motivation

Part III

Rate on a scale of 1-10 (10 being most important):