What kind of exercise do you do/how often?
What are your favorite hobbies/ things to do?
Health concerns and conditions
Dental Health and do you currently have mercury amalgams?
Brief Medical History and issues
Sleep quality 1-10 ____________
When do you typically go to sleep?
How refreshed do you typically feel 1-10 ______________
Occupation and work environment (describe it please)
How much do you drive?
How much do you work?
Have you detoxed your home?
Do you use any EMF protection?
Do you use a cell phone or cordless phone? Are you aware of the safe ways to use it?
Do you use artificial light? Blue Light Blocking glasses or bulbs?
Please tell me anything about your life that might help me get a picture of your situation so I can better assist you in your goals. Or anything you would like to share.