TAKE OUR GUT HEALTH ASSESSMENT
Find out if your gut health is at risk or not.
Gut Health assessment
Name
*
First
Last
Email
*
Do you crave Sweets or Starchy breads?
*
Yes
No
Sometimes
Do you eat junk food (things like chips, cookies, candy or fast food)?
*
Yes, everyday!
Yes, 3 to 5x's a week
Sometimes
No, never
Do you drink soda, sports drinks or fruit juices?
*
Yes, everyday
Yes, 3 to 5x's a week
Sometimes
No, never
Do you have any food allergies, sensitivities or intolerances?
*
Yes
No
Not sure
Do you get sick often? (more than 3x per year)
*
Yes
No
Have you taken antibiotics in the last 2 years?
*
Yes
No
Do you struggle with fatigue or low energy?
*
Yes
Sometimes
No, never
Do you have irregular bowel movements?
*
Yes
Sometimes
No
Do you have digestive issues like constipation, diarrhea, gas, bloating, burping or acid reflux?
*
Yes
Sometimes
No
Do you suffer from skin conditions itchy/dry skin, rashes, eczema, rosacea, acne, hives or psoriasis?
*
Yes
Sometimes
No
Do you have joint pain, soreness or arthritis?
*
Yes
Sometimes
No
Do you have high stress levels and/or severe anxiety?
*
Yes
Sometimes
No
Would you like to END your health concerns?
*
Yes
No, I don't have any
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