Allergy Food Sensitivity Test

Answer the following questions about yourself:

1.
Do you experience bloating, cramps, or abdominal distention after meals?
Yes
No
2.
Do you experience itching on the skin or rash after you eat a meal?
Yes
No
3.
Do you feel tired or exhausted after two or three hours after having a meal?
Yes
No
4.
Do you feel that your face, arms, or legs become numb for no specific reason?
Yes
No
5.
Do you suffer from frequent headaches or migraines?
Yes
No
6.
Do you have alternate bouts of diarrhea and constipation?
Yes
No
7.
Do you experience joint pain or aching muscles?
Yes
No
8.
Are you inclined to eat snacks frequently?
Yes
No
9.
Does any member in your family have a chronic skin condition or asthma, hives, or colitis?
Yes
No
10.
Are you averse to any food or beverage?
Yes
No
Please answer all of the questions before continuing.

Please provide us with your contact information to email your test results.

First Name:
Last Name:
Phone:
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