Nutritional Assessment

Please read this before your consultation.

Please complete this questionnaire as best you can. Don’t worry if you cannot answer all the questions, or find some ambiguous. We will have time to discuss these during your nutritional consultation.

For your first consultation, we will spend 60-90 minutes discussing your particular health problems or reason for attending, resulting in a recommended diet, lifestyle and supplement programme for you to follow. If you are under 16 it is a legal requirement that a guardian or parent be present. Anything you say or any information you give during a consultation is completely confidential.

Step 1 - Personal Info

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Step 2 - General Info

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3. Heredity & Lifestyle

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4. Symptoms

Section 1 – Digestion, Absorption & Elimination
Section 2 - Liver and Gallbladder
Section 3 – Blood Sugar
Section 4 – Immune System
Section 5 – Women Only
Section 6 – Thyroid
Section 7 – Adrenal
Section 8 – Cardiovascular
Section 9 – Stress Profile
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5. Diet & Analysis

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/*supplied by client 06Jul20*/