Questionnaire

1. Are you tired of feeling sick? Do you suffer from immune problems? Such as allergies, recurrent infections, or autoimmune conditions? Rate impact to quality of life 0 - 5. With 0 being never to 5 being always.
0 1 2 3 4 5

2. Are you sick of feeling tired? Do you feel tired all the time and suffer fatigue? Rate impact to quality of life 0 - 5. With 0 being never to 5 being very regular, once or more daily.
0 1 2 3 4 5

3. Do you suffer from brain fog and lack focus and concentration? Rate impact to quality of life 0 - 5. With 0 being never to 5 being almost every meal.
0 1 2 3 4 5

4. How often do you experience bloating, discomfort, or indigestion in the last 2 weeks? Rate impact to quality of life 0 - 5. With 0 being never to 5 being always.
0 1 2 3 4 5

5. How often do you suffer constipation or diarrhea? Rate impact to quality of life 0 - 5. With 0 being never to 5 being daily.
0 1 2 3 4 5

6. How often do you notice specific foods upset your guts? Rate impact to quality of life 0 - 5. With 0 being never to 5 being almost every meal.
0 1 2 3 4 5

7. Do you suffer from blood sugar problems or need a sugar hit after meals? Rate impact to quality of life 0 - 5. With 0 being never to 5 being almost every meal.
0 1 2 3 4 5

8. Do you have weak hair? Losing hair and thinning? Rate impact to quality of life 0 - 5. With 0 being no way I have great hair to 5 being yes, I am bald or going bald.
0 1 2 3 4 5

9. Do you have weak and flaking or brittle and breaking fingernails? Or are your fingernails odd-shaped and not growing properly? Rate impact to quality of life 0 - 5. With 0 being no to 5 being yes, my fingernails are bad.
0 1 2 3 4 5

10. Do you have dry, irritated, and lackluster skin? Or suffer from skin problems, infections, rashes, pigmentation, or scarring? Rate impact to quality of life 0 - 5. With 0 being no to 5 being yes, my skin is bad.
0 1 2 3 4 5