Do You Need to Detoxify?
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| Do you have headaches or other aches and pains? | YES | NO |
| Do you often eat fast foods, fried foods, or refined foods? | YES | NO |
| Do you regularly consume caffeine, sugar, or soda, or feel you need
these substances to have enough energy to survive your day? | YES | NO |
| Are you overweight or do you tend to overeat? | YES | NO |
| Do you have high blood pressure or elevated blood cholesterol? | YES | NO |
| Do you have allergies to foods or the environment, manifested
possibly as hay fever, skin rashes, or asthma? | YES | NO |
| Do you have allergies to foods or the environment, manifested
possibly as hay fever, skin rashes, or asthma? | YES | NO |
| Do you experience constipation, diarrhea, parasites, candida,
or other digestive problems? | YES | NO |
| Are you a regular drug user or abuser of over-the-counter,
prescription,or recreational drugs? | YES | NO |
| Do you smoke cigarettes or inhale second-hand smoke? | YES | NO |
| Do you use or abuse alcohol? | YES | NO |
| Do you often feel tired or experience fatigue? | YES | NO |
| Have you experienced a serious or chronic illness or disease? | YES | NO |
If you answered yes to two or more of these questions,
it is likely that you will benefit from a detoxification process.
Total "Yes": 0 - You probably do not need a detoxification process.
Please call our office at (949) 680-1880 to schedule an office visit or phone consultation for a personalized treatment plan that addresses your specific needs.
Print your completed questionnaire and present it to your practitioner for review.
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