Health Questionnaires

In order to be admitted to our Absolute Health Clinic, you will need to complete the three linked items below:

All patients need to complete the Daily Record of Food Intake before beginning any of the other items. It takes a week to complete it, so click on it now, print it, complete it during the week, scan it and return it when completed. In the mean time, you may complete the system survey below and the Toxicity Questionnaire as well as they will both be needed. They take several days to review so submitting them now will be helpful.

Click on the Link below and you will see a .pdf document. You should print this and complete it. Bring it with you on your next visit or scan the completed form and email it back to the email link at the bottom.

System Survey

On the form, you will have the opportunity to rate yourself and your symptoms with three levels of each situation. Please consider every question completely and take whatever time is necessary for you to provide accurate information. At the conclusion of the 200 questions, you will have the opportunity to provide a list of the five most important health issues you have. Please list them in order of most concerning to you first.

After you have completed the survey, bring the form on your next visit or scan it an email it back to using the link below. Once received, your information will be analyzed and a report will be sent to our office. You will notified via email that your report is ready and you will then need to schedule a time to meet with the doctor and discuss the results.

Email your completed scanned forms.