(Circle All That Apply)
 

Do You Smoke? - Add 10-35 Points
Less than 1/2 Pack a day (+10 Points)
1/2 Pack - 1 Pack a day (+15 Points)
1 - 2 Packs a day (+20 Points)
2 + Packs (+35 Points)

Do You Drink Alcohol? - Add 10-50 Points
3 Drinks or Less Per Week (+10 Points)
4-7 Drinks Per Week (+20 Points)
1-2 Drinks Per Day (+35 Points)
3-5 Drinks Per Day (+50 Points)

Do You Have Amalgam / "Silver" Filings? - Add 75-250 Points
2 - 4 Fillings (+75 Points)
5 - 8 Fillings (+150 Points)
9 + Fillings (+250 Points)

How Much Red Meat? - Add 5-40 Points
8 oz Per Week (+5 Points)
16 oz Per Week (+10 Points)
24 oz Per Week (+20 Points)
40 oz Per Week (+40 Points)

Do You Eat Pork? - Add 15-60 Points
Occasionally (+15 Points)
Often / Several Times Per Week (+30 Points)
Every Day (+60 Points)

Do You Drink Regular Soda? - Add 10-40 Points
Occasionally (+10 Points)
Often / Several Times Per Week (+25 Points)
Every Day (+40 Points)

Do You Drink Diet Soda? - Add 20-80 Points
Occasionally (+20 Points)
Often / Several Times Per Week (+50 Points)
Every Day (+80 Points)

Do You Eat Fast Food? - Add 20-100
1-2 Times Per Week (+20 Points)
5-7 Times Per Week (+50 Points)
1-2 Times Per Day (+100 Points)

Do You Eat Convenience Foods (Box, Bag, Can, Ready Eat etc.)? - Add 10-40 Points
Occasionally (+10 Points)
Often / Several Times Per Week (+25 Points)
Every Day (+40 Points)

Do You Take Drugs, Medications, or OTC Meds? - Add 15-75 Points
Occasionally (+15 Points)
1-2 Every Day (+30 Points)
3-5 Every Day (+50 Points)
5+ (+75 Points)

Do You Drink Coffee? - Add 15-50 Points
1-2 Cups Day (+15 Points)
3-5 Cups Day (+30 Points)
5+ (+50 Points)

Chemical / Environmental Exposure - Add 15-40 Points
If You Live or Work in Major City / Metro Area (+15 Points)
If You Work with Chemicals & / or Heavy Metals Regularly (+40 Points)

Do You Eat Refined White Products or Sugar? - Add 15-50 Points
A Serving Per Day (+15 Points)
1-3 Servings Per Day (+30 Points)
4+ Servings Per Day (+50 Points)

Do You Eat Fried Foods? - Add 20-150 Points
Occasionally (+20 Points)
Occasionally (With No Gallbladder) (+40 Points)
Often / Several Times a Week (+45 Points)
Often / Several Times a Week (With No Gallbladder) (+90 Points)
Every Day (+75 Points)
Every Day (With No Gallbladder) (+150 Points)

Do You Get Colds or Infections? - Add 15-100 Points
1-2 Times Per Year (+15 Points)
1-2 Times Per Year (With Antibiotic Use) (+30 Points)
3-4 Times Per Year (+30 Points)
3-4 Times Per Year (With Antibiotic Use) (+60 Points)
5+ Times Per Year (+50 Points)
5+ Times Per Year (With Antibiotic Use) (+100 Points)

Water Habits… - Add or Subtract
Drink Fair Amount of Unfiltered / Tap Water (+50 Points)
Almost Never Drink (+50 Points)
Drink Some Daily (but not primary drink) (+25 Points)
Drink 1/2 Body Weight In Oz Every Day (-40 Points)
Drink 3-4 oz in Regular intervals (30 minutes etc.) - Deduct another…(-40 Points)

Bowel Habits… - Add or Subtract
1-2 Times Per Week (+75 Points)
3-5 Times Per Week (+35 Points)
1 Every Day (-10 Points)
1-2 Times Per Day (-25 Points)
2-3 Times Per Day (-45 Points)

Fresh Fruits & Veggies… - Add or Subtract
Less Than 2 Servings Per Day (+30 Points)
2-3 Servings Per Day at least 1 Serving Raw (-15 Points)
4-5 Servings Per Day at least 1 Serving Raw (-25 Points)
5 + Servings Per Day half + Raw (-40 Points)
If Bulk of Produce is Organic (-20 Points)

Do You Eat Raw Live / Cultured Foods - Subtract 10-60 Points
(Yogurt, Kefir, Buttermilk, Acidophilus Milk etc.)
Occasionally (-10 Points)
Often / Several Servings Per Week (-30 Points)
Every Day (-60 Points)

If Supplements Are Taken Regularly & Consistently… - Add or Subtract
Synthetic / Fractionated Vitamins / Supplements (+20 Points)
Digestive Enzyme (-30 Points)
Bulk Fiber / Psyllium Husk (Flavored W/ Sugar or Sugar Substitute) (-30 Points)
Bulk Fiber / Psyllium Husk Unflavored (-40 Points)
Whole Food Concentrate Multi Vitamin / Mineral (-20 Points)


 

Scoring The Damage

0 – 150 Points: Congrats… You most likely have a clean bio-terrain and are most likely blessed with very good health. Keep up the good work!

151 – 300 Points: You are about as toxic as the next guy. That’s not saying much!... Most likely you are beginning to “feel” and experience the effects of toxicity and autointoxication. It might prove extremely beneficial for you to explore means for reducing your toxic load and / or explore avenues for detoxification and support of elimination organs.

301 – 400 Points: Chances are you KNOW you’re toxic. At this point you probably see it, feel it, smell it, and taste it! Don’t wait to begin making better nutritional, supplemental, & lifestyle choices - Most people can only truly appreciate good health once they have lost it.

401 + Points: 1st Check your pulse… 2nd, (If you’re still breathing) schedule an initial consultation. We will help you put together a plan of action to get you back on track and reach your wellness goals.

 

These are some of the most common sources of toxicity but by no means all of them. When multiple sources and factors are added together, it can greatly impair the body's ability to "keep up" with the toxic load. This free assessment is not meant as a diagnosis, prognosis or an indication of any disease or illness. If you suspect you have a disease or illness, make an appointment with your primary care physician. This is a self-assessment tool designed to educate our clients about making better nutritional, supplemental, and lifestyle choices for their self-care.