FIND OUT HOW WELL YOUR GUT IS FUNCTIONING BY ANSWERING A FEW SIMPLE QUESTIONS
(and we’ll share a few tips on how to take steps to help heal)
WHY DO YOU NEED A GUT HEALTH ASSESSMENT?
YOU HAVE UNEXPLAINED BLOATING AT "RANDOM" TIMES.
YOU HAVE FOOD SENSITIVITIES.
YOU'RE EITHER CONSTIPATED OR HAVE DIARRHEA.
YOU WANT TO IMPROVE YOUR HORMONES.
YOU HAVE SKIN ISSUES LIKE RASHES, ACNE, OR ECZEMA.
YOU HAVE TROUBLE LOSING WEIGHT
First, lets get your name!
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Do you have any medical conditions you wish to disclose? (I.E. diabetes, hypothyroid, high cholesterol, etc) *
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How many calories on average are you eating per day?(if not tracking, provide a rough estimate) *
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How would you rate your food quality? *
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How would you rate your daily energy levels? *
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How would you rate your daily stress levels? *
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How would you rate the quality of your sleep? *
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How active are you? *
Sedentary
Moderately Active
Active
Highly Active
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This assessment is not about coaching but are you interested in hearing more about 1 on 1 coaching? *
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Select which symptoms apply to you.
Choose as many as you like
I have gas
I have bloating
I have difficulty passing stools.I have discomfot and/or belching after meals
I have constipation
I have difficulty passing stools.
I have food sensitivities
I have irritable bowel syndrome (IBS)
I have Crohn's disease or ulcerative colitis
I have an autoimmune disease
N/A
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Select which symptoms apply to you.
Choose as many as you like
I have heartburn
I take acid-blocking medication more than once a year
I experience nausea after meals
I am nauseous often
I have rashes, eczema, acne, or hives
I have foul smelling stools
I see undigested food in my stools (other than nuts, seeds or corn)
I have cravings for sugar, simple carbs, or alcohol
I need stimulants (natural or drug) to have a bowel movement
N/A
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Select which symptoms apply to you.
Choose as many as you like
I see mucus in my stools
My tongue is swollen or has a thick coat
I experience anal itching
I use NSAIDS like ibuprofen or naproxen regularly
I have taken antibiotics more than once in the last year
I have taken the birth control pill
N/A
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