Digestive Health Assessment

Answer a few questions so we can understand what’s going on and recommend the best next step.

Could Your Digestion Be the Root Cause of Your Symptoms?

This short assessment helps us understand what may be affecting your digestion and which next step would support you best.

Most people complete it in under 2 minutes.

1. Which best describes your current digestive issue?

Gas / Bloating Acid regurgitation after eating Constipation Diarrhea Irregular bowel movements Other

2. How long have you been struggling with this issue? What have you tried so far?

3. If things were working properly, how would you like to feel in the next 30 days?

4. Which type of support feels most helpful right now?

Digestive reset kit One-hour private Zoom consultation In-person digestive health visit Not sure — I’d like guidance

5. Which best describes your current role or lifestyle?

Professional / technical role Business owner / executive Parent / caregiver Student Retired

6. Is there anything else about your health concerns you’d like us to know?

Where should we send your results and next steps? Email First name Last name

Your information is private and secure.

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