Understand your individual inflammation level
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Question 1 of 9
Hello,
We have designed this brief questionnaire to get an idea of what your current level of inflammation is within your body.
What is your full name?
Question 2 of 9
What is your email address?
Question 3 of 9
What is the best phone number to reach you at if needed?
Question 4 of 9
How often do you feel bloated, gassy and/or have stomach distention or abdominal pain after eating or in-between meals?
Never
Rarely
Sometimes
Often
Always
Question 5 of 9
How often do you experience headaches or migraines?
Question 6 of 9
How often do you find yourself having unexplained mood swings, lack of motivation, depression, anxiety or worry?
Question 7 of 9
Do you find yourself getting sick more frequently? Also, when you are sick do the symptoms appear more severe than in the past, and do you experience difficulties with recovery?
Question 8 of 9
How often do you have difficulty falling asleep, staying asleep or waking in the middle of the night and can't fall back to sleep, or feel rested after a night of sleep?
Question 9 of 9
Females:
Do you have heavy or irregular periods, severe cramping, extreme breast tenderness, facial hair, acne or loss of libido?
Males:
Do you have hair loss, erectile dysfunction, decreased libido, breast formation?