Comprehensive Health Questionnaire

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Comprehensive Health Questionnaire 2017-05-09T20:57:15+00:00

One of my mentors, Dr. Datis Kharrazian, developed this amazing assessment that can quickly help me identify critical issues.  Please take the time to complete the questionnaire and we will offer you individualized practical advice.

 

Name:*
E-mail:*
Your Sex*
Date of Birth:*
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Section 1
Section II
Section III
Section IV
Section V
Section VI
Section VII
Section VIII
Section IX
Section X
Section XI
Section XII
Section XIII
Section XIV (Males Only)
Section XV (Males Only)
Section XVI (Menstruating Females Only)
How many years have you been menopausal?
Section XVII (Menopausal Females Only)
Section A
Section B
Section C
Section D

Thank you for completing our assessment. We will review your information and get back to you with suggestions.

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