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Ready to assess your health? Complete the short survey below and get your INSTANT RESULTS.
Survey should take about 5-8 minutes to complete.

Water

1.

Do you use a whole house water filtration system

Yes No

2.

Do you drink a minimum of eight 8oz glasses of pure spring water per day?

Yes No

3.

Do you drink bottled water in plastic bottles?

Yes No

4.

Do you drink alkaline water?

Yes No

1 out of 11

Sleep

5.

Do you fall asleep within 15 minutes of laying down?

Yes No

6.

Do you have electronics in room where you sleep, i.e cell phone, laptop, or TV?

Yes No

7.

Do you wake up during your sleep cycle?

Yes No

8.

Do you sleep seven hours per night?

Yes No

2 out of 11

Chiropractic

9.

Do you receive chiropractic adjustments at least once per month?

Yes No

10.

Do you do exercises to promote a cervical curve in your neck?

Yes No

11.

Do you believe that chiropractic care is used as prevention in healthcare?

Yes No

12.

Do you hold your cell phone above eye level when reading or texting?

Yes No

3 out of 11

Acupuncture

13.

Do you receive acupuncture work monthly?

Yes No

14.

Do you believe acupuncture can be used prevention in healthcare?

Yes No

15.

Do you use for pain relievers for various pain throughout the body?

Yes No

16.

Do you experience radiating pain/sensations throughout the body?

Yes No

4 out of 11

Massage

17.

Do you get a massage weekly from a licensed massage therapist?

Yes No

18.

Do you believe massage therapy can add to your preventative healthcare?

Yes No

19.

Do you have a history of any soft tissue injuries? Sprains, strains, etc.?

Yes No

20.

Do you experience poor circulation?

Yes No

5 out of 11

Cognition

21.

Do you read a minimum of 30 minutes per day?

Yes No

22.

Do you drink Organic Green Tea daily?

Yes No

23.

Do you use Full Spectrum lighting in your home, not fluorescent?

Yes No

24.

Do you take a prescription to control blood sugar or diabetes?

Yes No

6 out of 11

Relaxation

25.

Do you live a high stress life?

Yes No

26.

Do you meditate regularly?

Yes No

27.

Do you laugh out loud often?

Yes No

28.

Do you listen to music for at least 40 minutes per day?

Yes No

7 out of 11

Fuel

29.

Do you eat 90% organic foods?

Yes No

30.

Do you eat packaged or canned foods?

Yes No

31.

Do you eat simple carbohydrates, bread, pasta, candy, donuts regularly?

Yes No

32.

Do you eat 80% of your meals at home?

Yes No

8 out of 11

Movement

33.

Do you go for daily walks for 30 mins?

Yes No

34.

Do you elevate your heart rate through exercise for more than 30 minutes three times a week?

Yes No

35.

Do you actively stretch daily?

Yes No

36.

Do you participate in hobbies that are active, such as bowling, basketball, softball, etc?

Yes No

9 out of 11

Nature

37.

Do you spend a minimum of 60 minutes per day outside?

Yes No

38.

Do you get 15 minutes of sun exposure per day?

Yes No

39.

Do you spend at least 60 minutes per week in the natural environment near where you live. Beach, Mountains, parks, etc.?

Yes No

40.

Do you walk barefoot daily for at least 20 minutes in a natural environment, sand, grass, dirt, etc.?

Yes No

10 out of 11

Air

41.

Do you change your homes air filter every 90 days?

Yes No

42.

Do you drive a car more than 30 minutes a day?

Yes No

43.

Do you use air fresheners in your home or work environment?

Yes No

44.

Do you run air conditioning in your home, work, or car more than 2 days per week?

Yes No

11 out of 11

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Home
Areas of Health
- Water
- Sleep
- Chiropractic
- Acupuncture
- Massage
- Cognition
- Relaxation
- Fuel
- Movement
- Nature
- Air
Wellness Continuum
Daily Dose
Private Clients
Buy Supplements
Assess My Health

Menu

Home
Areas of Health
- Water
- Sleep
- Chiropractic
- Acupuncture
- Massage
- Cognition
- Relaxation
- Fuel
- Movement
- Nature
- Air
Wellness Continuum
Daily Dose
Private Clients
Buy Supplements
Assess My Health

Water

Sleep

Chiropractic

Acupuncture

Massage

Cognition

Relaxation

Fuel

Movement

Nature

Air

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