Scorecard Audit:
Congratulations on taking the next bold step to unraveling your food sensitivity mystery.
Answer each question below.
That way we can give you the most specific "How To" and "next steps", so that you can benefit the most from your audit!
There are no wrong answers, you can say anything.
It's all about
RESULTS
for you.
[
Note
:
Any information you learn from the audit, tool or this site should be shared with your health care professional. Nothing here should be considered medical advice or recommendations and is only for informational purposes only. Do NOT send medical information. This is NOT a medical info secured page. Ed it NOT a medical professional or doctor.]
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Indicates required field
First Name
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Primary Email
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How long have you suspected food sensitivity?
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I've only recently began considering it as a possibility.
About the last year or so.
I've suspected for a very long time.
How long have you sufferend with your MAIN ailment or symptom?
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A couple months.
For the past year.
For years.
On and off for years.
Thinking only of your MAIN ailment -
How many bad days do you have each week/month?
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1 or 2 "Bad" Days a week.
3 or 4 "Bad" Days a week.
5 or 6 "Bad" Days a week.
7 - everyday is a severe day
2 or 3 "Bad" Days a month.
Which solutions have you tried in the past?
(click all that apply)
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General Doctor
More than one Doctor
Perscription
Specialist
Functional Doctor
Integrative Doctor
Surgury
Supplements/vitamines
Lotions, salves or ointments
Elimination diet
Special diet
Tracked food with pen and paper
Other
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Do you experience any of these "
micro-ailments
"? Choose all that apply.
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Headaches
Itchy, dry or problem skin
Hagardly and tired looking
Rosy/red cheeks, nose, neck or ears
Nasally voice
Watery eyes
Phantom anxiety or stress
Muscles twitches
Phlegm (frequent throat clearing)
"Sticky Eyes" in the morning
Fatigue morning or afternoon
More colds per year than friends
Yo-yo weight fluctuations
Extra pounds despite "eating clean"
Stuffy nose (even slightly)
Runny nose, eyes or ears (even slightly)
"Foggy mind" issues
Muscle, back, neck or joint aches
Anxiousness or restless sleep
Dark circles around eyes
Stomach aches, gas or gas pain
Frequent diarrhea
Racing heartbeat
Resting pulse over 84 bpm
Concentration/focus issues
micro-ailments"? Choose all that apply." class="wsite-form-instructions" style="display:none;">
Do you already suspect/know what "triggers" some of your ailments?
Please briefly explain.
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Have you experienced your pulse sometimes increasing or racing for no apparent reason?
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Yes
No
Is your resting pulse (seated in a chair) over 84 beat per minute?
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Yes
No
I don't know
What are your thoughts about Food Sensitivity and Food Intolerance?
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I'm very skeptical and believe many mystery ailments and symptoms are in people's heads or something else in the body. But because of my personal mystery ailment, I'm beginning to open to the possibilities.
I was skeptical, but as I've learned more about about food science, it's becoming more and more obvious to me that food has a huge impact on how I feel.
It's obvious food sensitivity and food intolerance are very real - Everything points to a food sapping my energy and making me feel bad. I just DO NOT know which food is the trigger food!
What is your biggest challenge/fear as it relates to your ailment?
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How would your life change if you found the specific food that was triggering your ailment and symptoms?
(family, career, hobbies, quality of life, friends, activities)
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If we were having this discussion
1 year from today,
and you were looking back over that year,
what has to have happened in your life for you to feel happy with your progress and results?
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Do you have
1 to 3 minutes available each day
to use the tool. (
you can use the tool from anywhere you have internet - grocery store line, while watching TV or from work.
)
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If accepted,
are you committed to using the tool to find your trigger foods and to solve your mystery ailment?
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If I like the tool and it's easy to use...I'm VERY commited to using it to find my Trigger Foods and solving my ailment mysteries.
I'm somewhat committed. Finding a solution is important to me.
I have a lot going on in my life right now..but I'll do what I can.
Is there anything else I can help you with today?
If you have any questions or comments please enter them below.
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Click Submit when you're ready.
Keep a lookout for an email from me. (Ed Toups)
Submit
