• Head

    • EYES

    • EARS

    • NOSE

    • MOUTH/THROAT

    • SKIN

    • HEART

    • DIGESTIVE TRACT

    • LUNGS

    • JOINTS/MUSCLES

    • WEIGHT

    • ENERGY/ACTIVITY

    • MIND

    • EMOTIONS

    • OTHER

  • KEY TO QUESTIONNAIRE

    Grand total: Optimal: < 10 | Mild Toxicity: 10-50 | Moderate Toxicity: 50-100 | Severe Toxicity: >100