Autoimmune SurveyAutoimmune Surveyhttp://allergyexpert.squarespace.com/autoimmune-survey/2008-11-05T04:39:03ZSquarespaceAutoImmune Disease is Risky Business. Take this Survey and Find out where you stand!http://allergyexpert.squarespace.com/autoimmune-survey/2007/11/28/autoimmune-disease-is-risky-business-take-this-survey-and-fi.htmlDR. TED EDWARDS2007-11-28T02:02:14Z2007-11-28T02:02:14ZProvide your answers and
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I’m Still able to offer Free Consultations - No autoresponder!

E-mail Address: *
In the recent past have you? (check all that apply) * Eaten any Wheat or Corn
Been sick causing you to take Anti-Biotics
Had boughts of bloating
Felt tired, fatigued or frazzeled during the day
Been told you have a Thyroid or Adrenal Problem
Experienced chronic pain - like Fibromyalgia or RA
Wondered if the things you are taking are working
Felt like you have Brain Fog or Memory Loss
I Suffer From (mark all the apply) High Blood Pressure and/or Heart Disease
Aches and/or Pain that will not go away
Bleeding Gums (Peridontal Disease)
Belly Fat and/or Weight Gain
Morning Stiffness - Arthritis
Burnout, Depression, Anxiety Disorder
Skin sores / Rashes that you cannot get rid of
Allergies / Sinus Problems
Deteriorating Health over several years
Rheumatoid Arthritis, Diabetes, Lupus
A chronic injury / infection
How bad are things now?
How often do your symptoms occur?
Do you have an idea what is going wrong?
What kind of treatment or supplements do you prefer? * I prefer things I can use to heal myself. I am a do-it-yourselfer
Something hands-on like Chiropractic, Naturopathic or Accupuncture
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 would like to fix things permanently with DNA Reprograming
How Old do you Hope to be When you Pass Away? Less than 70
70-80
81-90
91-100
101-110
111 and beyond
First name: *
Last name: *
Male, Female - Age Male
Female
17 or under
18-29
30-39
40-49
50-59
60-69
70+
Contact Phone Number *
Free 15 minute Consultation - a $22.50 Value *
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