Questionnaire

Your journey to a more optimum you begins here. Simple, science-based diagnostics give you the keys to unlock your personalized health insights.

For the next 10-15 minutes we will be getting to know you. Let's start with the basics.

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These give surprising insight into why you might lack nutrients and experience certain symptoms.

Mostly / Sometimes / No
Dairy/meat & eggs
Fruits & vegetables
Oils (for thing like dressings, cooking or supplements).

Choose all that apply












Believe it or not, each of these can indicate a different vitamin & mineral imbalance or deficiency. We cross reference your test results and symptoms to deliver your personalized recommendations.

Sleep is hugely affected by nutrient levels. We will find out yours.

Yes / Sometimes / No
Have difficulty falling asleep
Wake up in the middle of the night tossing and turning
Sleep 8 hours, but don’t feel rested upon waking

Yes, this can be improved by identifying & replenishing missing nutrients.

Yes / Sometimes / No
Do you crave sweets or carbs
Energy swings/dips
Do you have trouble concentrating
Lethargy in the morning, higher energy at night
Lethargy continuous
Memory problems

It's not just you, mood can be hugely impacted by vitamins & minerals.

Yes / Sometimes / No
Anxiety or panic during the day
Anxiety or panic at night
Frequently frustrated, agitated or angered
Prone to depression or sadness

Key minerals like magnesium, and the right oils are frequently involved here.

Yes / Sometimes / No
Muscle cramping
Sore knee(s)
Sore hip(s)
Sciatica pain
Restless legs (usually at night)
Tennis elbow or sore forearms
Shoulder pain
Neck pain
Upper back pain
Lower back pain
Foot pain when walking or running
Achilles pain, calf cramps, and/or shin splints
Crooked wrists, fingers, or toes
Osteoarthritis
Disc degeneration
Bone spurs

Did you know that congested lungs can mean a tired liver? Our programs will help.

Yes / Sometimes / No
Irregular heart rhythm
Heavy heart beat when lying on left side
Shortness of breath
Asthma
Cold hands or feet
Varicose veins
Do you have gout?
Numbness in face, arms or hands
Numbness of neuropathy affecting legs or feet
Excess phlegm & mucus
Have you had pneumonia in the past?
Lungs frequently congested
Dizziness upon standing
Dizziness other
Have you had hepatitis or other liver problems

Chances are screen time makes your eyes work overtime.

Yes / Sometimes / No
Headaches (frontal)
Headaches (other)
Poor night vision
Eye strain

Did you know that fiber and other supplements can help grow healthy gut bacteria?

Yes / Sometimes / No
Gas or bloating
Abdominal cramping
Stomach pain or ulcer
Heartburn
Hemorrhoids
1 bowel movement or less per day
Constipation
Frequent diarrhea

Minerals like magnesium and specific vitamins can reduce trips to the bathroom at night. They just needs to be in the right form.

Yes / Sometimes / No
Frequent bladder infections
Frequent urination during the day
Frequent urination at night

Sexual health is a good sign of overall health.

Yes / Sometimes / No
Decreased sex drive

These pesky symptoms can usually be improved through supplements and nutrition.

Yes / Sometimes / No
Frequent colds
Frequent nose bleeds
Frequent ear infections
Bad breath
Bleeding gums
Frequent cankers
Frequent cold sores or herpes outbreaks
Metallic taste on tongue

Skin problems, like warts for example, have been linked to an imbalance between Zinc & Copper. Our analysis will pick it up.

Yes / Sometimes / No
Warts
Frequent shingles
Dry skin
Oily skin
Blemishes or acne
Skin rashes
Psoriasis
Eczema
Depigmentation (loss of natural skin color)
Age spots

Sometimes if your Calcium is too high compared to other minerals, it can make your nails brittle.

Yes / Sometimes / No
Dandruff
Occasional hair loss
Brittle hair
Brittle nails
Ridges in fingernails
White spots in fingernails
Nail fungus or athlete's foot

These can be helped by getting your zinc to copper more balanced. We'll let you know if you fall into this group! Exercise can really help here, but minerals, vitamins and other nutrition can also help relieve these symptoms.

Yes / Sometimes / No
Seasonal or hay fever
Dairy, wheat, nuts or shellfish

This list does not contain all food groups, your hair analysis will see all the minerals you are getting from your diet. These questions reveal specific drivers of your test results.

Think of the number of times you use them in cooking, dressings or on their own.

Olive oil
Coconut oil
Flax oil
Sun of safflower oil
Pumpkin seed or hemp oil
Cod liver or other fish oil
Krill oil
Vegetable oils (i.e. soybean, corn, canola, peanut, sesame, mazola...)
Mayonnaise
Butter
Cream or whipping cream
Margarine
Hot dogs
Non-organic luncheon meats/cold cuts
Non-organic red meat
Predator fish (i.e. tuna, swordfish or halibut...)
Crustaceans (i.e. shrimp, lobster, crab, oysters...)
Fast food
Frozen dinners
French fries
Other deep fried foods
Potato chips
Corn or tortilla chips
Fruit
Fruit juice
Fruit yogurt
Table sugar (teaspoons)
Ketchup
Ice cream
Cookies, muffins or granola bars
Doughnuts
Chocolate (organic 85%+ cocoa)
Chocolate (organic)
Chocolate (regular)
Packaged breakfast cereals
Pasta or bread
Iodized salt (tends to be plain old salt shaker salt and at restaurants)
Non-iodized salt (tends to be more granular sea salts)
Coffee
Caffeinated tea
Energy drinks
Sport drinks & other



We will send the results of your nutritional assessment and personalized vitamin recommendation via email as soon as our lab has processed your hair test kit.



While you’re here, check out our blog for the latest on staying healthy.

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