| LIFESTYLE INFORMATION |
| Present Medical Complaints |
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Relevant Medical History |
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| Family Medical History |
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| Current Medications (herbs, supplements,
medications) |
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| Confirmed Diagnostic Tests and Blood
Results |
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| Are you allergic to anything? and if so
what? |
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| NUTRITIONAL INFORMATION |
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Do you take any Toxins, eg. Coca-cola, cigarettes,
alcohol, coffee, etc. |
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Briefly describe your eating habits and favourite foods? |
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How regularly do you eat?
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How do you feel after eating? |
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| STRESS
MANAGEMENT |
| How do you handle Stress? |
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| Define your sleeping patterns. How many
hours do you sleep? |
|
| What do you do for exercise and how
often? |
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| Do you live your passion in your life? |
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| How regular are your bowels? |
|
| What do you do for pleasure and
relaxation? |
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