| What are you allergic to? * |
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| Describe What Happens? How does your body react? Coughing, sneezing, runny nose, itchy eyes? |
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| On a scale of 1-10: How Bad are Your Allergies |
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| What kind of Allergy Treatments have you tried? * |
Allergy Shots
Medications like Claritin, Allegra
Bronchial Inhaler sometimes
Alternative Allergy Care like NAET |
| What kind of Therapies do you Prefer? * |
I prefer things I can use to heal myself. I am a do-it-yourselfer
Taking Nutritional Supplements (pills) works for me
I use protein drinks, green drinks, tinctures
I take prescription drugs, but I do not like them
I want to use DNA Allergy Reprogramming to eliminate my allergies permanently |
| Your Name: * |
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| E-mail Address: * |
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| Schedule a Free Phone Consult with Ted Edwards DC at |
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