Please complete this form, noting your diet and lifestyle patterns, health concerns, and potential toxicity. The purpose of this is for you to take note of both healthy and unhealthy foods in your diet, beneficial and detrimental lifestyle practices, personal health issues, and possible toxic burden. 

We have all heard that we are what we eat. To be more accurate, we are what we assimilate into our cells and body tissues. Today we are living in an environment that is loaded with toxins that find their way into the air we breathe, the water we drink and food we eat.

When you view "Your Assessment" scores, you may wish to print the Assessment page for your records.
 
By noting your score from the Diet Evaluation Part 1 - "Nutrition Bandits", which inventories highly-refined, chemical-laden, low-nutrient foods, and then comparing that score with your score from the Diet Evaluation Part 2 - "Nutrition Heroes", which tallies your consumption of fresh, seasonal, local and unprocessed foods, you can get an idea of where to make changes.

A review of your scores from the Lifestyle Evaluation Parts 1 and 2 will indicate the areas of stress and imbalance that may be compromising your health and vitality.

Your Health Concerns score will give you a sense of the issues which may be holding you back from complete vitality and health.

Your Toxicity score will provide an index of the toxic load you may be carrying.

Once you have completed this survey, we will contact you to discuss the findings and advise you on the services and programs we offer which can help you make the changes in your diet and lifestyle that will pay off in terms of improved energy, mood, metabolism and comfort.
 

Generally, we will contact you within 2 business days to arrange for follow-up.

Please visit our website to learn more about our services and Eating for Health.

www.BaumanNutrition.com