Are you currently exercising (regular walks qualify)?*
Yes
No
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Do you wake feeling rested?*
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No
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Do you fall asleep easily at bedtime?*
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No
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Do you feel you need a nap to function throughout the day?*
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No
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Do you feel energized after a meal or does eating a meal make you feel sleepy/low energy?*
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No
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Do you have frequent headaches?*
Yes
No
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Is losing weight a goal/priority to you?*
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No
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Do you crave specific foods or crave sugar?*
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No
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Do you experience any regular muscle cramping, weakness, or lightheadedness?*
Yes
No
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Do you have any regular indigestion/acid reflux?*
Yes
No
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Well formed or loose?*
Well formed
Loose
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Easy to pass or difficult?*
Easy to pass
Difficult
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Any regular joint pains?*
Yes
No
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Do you get sick easily?*
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No
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Do you have seasonal allergies?*
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No
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Female Clients Only:
Do you currently have a monthly cycle?
Yes
No
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Do you struggle with any PMS symptoms?
Yes
No
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