Detoxification Test

Answer the following questions about yourself:

1.
Do you frequently experience constipation or diarrhea?
Yes
No
2.
Do you experience emotional problems along the lines of mood swings or depression?
Yes
No
3.
Have you been faced with fatigue and sluggishness for a prolonged period of time?
Yes
No
4.
Do you suffer watery and itchy eyes?
Yes
No
5.
Do you experience faintness and headaches frequently?
Yes
No
6.
Are you often faced with shortness of breath or difficulty in breathing?
Yes
No
7.
Are you having problems remembering things or poor memory?
Yes
No
8.
Do you suffer from recurrent stuffy nose, sneezing attacks, or sinus problems?
Yes
No
9.
Do you have skin problems that involve acne, rashes, or dry skin?
Yes
No
10.
Have you experienced pain or aching in joints for a long time?
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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