check

Toxicity Questionnaire Pre-Assessment

Toxicity Questionnaire

How high is your need for a liver reset program?

Click the button below to start.

Start

Section 1 : DIGESTIVE

Rate  each of the following  based on your health profile for the past 90 days.

Question 2 of 101

Nausea and/or Vomiting

 

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 3 of 101

Diarrhea

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 4 of 101

Constipation

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 5 of 101

Belching and/or passing gas

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 6 of 101

Heartburn

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

2. EARS

Rate  each of the following  based on your health profile for the past 90 days.

Question 8 of 101

Itchy Ears

A

0 - Rarely or Never Experience the Symptom

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 9 of 101

Earaches or ear infections

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 10 of 101

Drainage from ear

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 11 of 101

Ringing in ears or hearing loss

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

3. EMOTIONS

Rate  each of the following  based on your health profile for the past 90 days.

Question 13 of 101

Mood swings

 

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 14 of 101

Anxiety, Fear, or Nervousnes

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 15 of 101

Anger, Irritability

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 16 of 101

Sense of Despair

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 17 of 101

Uncaring or Disinterested

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

4. ENERGY/ACTIVITY

Rate  each of the following  based on your health profile for the past 90 days.

Question 19 of 101

Fatigue or Sluggishness

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 20 of 101

Hyperactivity

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 21 of 101

Restlessness

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 22 of 101

Insomnia

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 23 of 101

Startled awake at night

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

5. EYES

Rate  each of the following  based on your health profile for the past 90 days.

Question 25 of 101

Watery or Itchy Eyes

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 26 of 101

Swollen, Reddened, or Sticky Eyelids

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 27 of 101

Dark Circles Under Eyes

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 28 of 101

Blurred or tunnel vision

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

6. HEAD

Rate each of the following based on your health profile for the past 90 days.

Question 30 of 101

Headaches

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 31 of 101

Faintness

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 32 of 101

Dizziness

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 33 of 101

Pressure

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

7. LUNGS

Rate each of the following based on your health profile for the past 90 days.

Question 35 of 101

Chest Congestion

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 36 of 101

Asthma or Bronchitis

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 37 of 101

Shortness of Breath

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 38 of 101

Difficulty breathing

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

8. MIND

Rate  each of the following  based on your health profile for the past 90 days.

Question 40 of 101

Poor Memory

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 41 of 101

Confusion

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 42 of 101

Poor Concentration

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 43 of 101

Poor Coordination

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 44 of 101

Difficulty Making Decisions

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 45 of 101

Stuttering, Stammering

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 46 of 101

Slurred Speech

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 47 of 101

Learning Disabilities

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

9. MOUTH/THROAT

Rate each of the following based on your health profile for the past 90 days.

Question 49 of 101

Chronic Coughing

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 50 of 101

Gagging or Frequent Need to Clear Throat

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 51 of 101

Swollen or discolored tongue, gums, lips

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 52 of 101

Canker sores

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3- Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

10. NOSE

Rate each of the following based on your health profile for the past 90 days.

Question 54 of 101

Stuffy Nose

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 55 of 101

Sinus Problems

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 56 of 101

Hay Fever

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 57 of 101

Sneezing Attacks

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 58 of 101

Excessive Mucous

 

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

11. SKIN

Rate each of the following based on your health profile for the past 90 days.

Question 60 of 101

Acne

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 61 of 101

Hives, rashes, or dry skin

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 62 of 101

Hair loss

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 63 of 101

Flushing

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 64 of 101

Excessive sweating

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

12. HEART

Rate each of the following based on your health profile for the past 90 days.

Question 66 of 101

Skipped Heartbeats

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 67 of 101

Rapid heartbeats

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 68 of 101

Chest pain

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

13. JOINTS/MUSCLES

Rate each of the following based on your health profile for the past 90 days.

Question 70 of 101

Pain or aches in joints

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 71 of 101

Stiffness or limited movement

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 72 of 101

Pain or aches in muscles

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 73 of 101

Recurrent back aches

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 74 of 101

Feeling of weakness or tiredness

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

14. WEIGHT

Rate each of the following based on your health profile for the past 90 days.

Question 76 of 101

Binge eating or drinking

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 77 of 101

Craving certain foods

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 78 of 101

Excessive weight

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 79 of 101

Compulsive eating

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 80 of 101

Water retention

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 81 of 101

Underweight

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

15. OTHER

Rate each of the following based on your health profile for the past 90 days. 

    

Question 83 of 101

Frequent illness

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 84 of 101

Frequent or urgent urination

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 85 of 101

Leaky bladder

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Question 86 of 101

Genital itch, discharge

A

0 - Rarely or Never Experience the Symptoms

B

1 - Occasionally Experience the Symptoms, Effect is Not Severe

C

2 - Occasionally Experience the Symptoms, Effect is Severe

D

3 - Frequently Experience the Symptoms, Effect is Not Severe

E

4 - Frequently Experience the Symptoms, Effect is Severe

Disclaimer:

The toxicity questionnaire has not been evaluated by the FDA and is intended for educational purposes only. It is not intended to diagnose, treat, cure or prevent any disease. If you are concerned about any symptoms,  please consult a medical professional.

How did you do?

If your total score is over 40 then you probably need a reset.

Score under 40? Check your email for the detailed report. If any individual section is over 6 then you could benefit from a reset anyway.

SECTION II: RISK OF EXPOSURE

Rate each of the following situations based upon your environmental profile for the last 120 days:

Question 89 of 101

How often are strong chemicals used in your home?

(Disinfectants, bleaches, oven and drain cleaners, furniture polish, floor wax, window cleaners, etc.)

A

0: Never

B

1: Rarely

C

2: Monthly

D

3: Weekly

E

4: Daily

Question 90 of 101

How often are pesticides used in your home?

A

0: Never

B

1: Rarely

C

2: Monthly

D

3: Weekly

E

4: Daily

Question 91 of 101

How often do you have your home treated for insects?

A

0: Never

B

1: Rarely

C

2: Monthly

D

3: Weekly

E

4: Daily

Question 92 of 101

How often are you exposed to dust, overstuffed furniture, tobacco smoke, mothballs, incense, or varnish in your home or office?

 

A

0: Never

B

1: Rarely

C

2: Monthly

D

3: Weekly

E

4: Daily

Question 93 of 101

How often are you exposed to nail polish, perfume, hairspray, or other cosmetics?

A

0: Never

B

1: Rarely

C

2: Monthly

D

3: Weekly

E

4: Daily

SET B

Rate each of the following situations based upon your environmental

profile for the last 120 days:

Question 95 of 101

Have you noticed any negative change in your health since you moved into your home or apartment?

A

0: No

B

1: Mild Change

C

2: Moderate Change

D

3: Drastic Change

Question 96 of 101

Have you noticed any change in your health since you started your current job?

A

0: No

B

1: Mild Change

C

2: Moderate Change

D

3: Drastic Change

YES/NO

Answer yes or no to the following questions:

Question 98 of 101

Do you have a water purification system in your home?

A

Yes

B

No

Question 99 of 101

Do you have any indoor pets?

A

Yes

B

No

Question 100 of 101

Are you a dentist, painter, farmer, or construction worker?

A

Yes

B

No

Question 101 of 101

Do you have an air purification system in your home?

A

Yes

B

No

Confirm and Submit