Fill out the form and schedule a call! "*" indicates required fields Step 1 of 2 50% EmailThis field is for validation purposes and should be left unchanged.Name* First Last PhoneEmail* This field is hidden when viewing the formServicesFirst ChoiceSecond ChoiceThird ChoiceGAPS Symptoms QuestionnairesDo you have any of the following symptoms Digestive problems Fatigue Muscular weakness Cramps and abnormal muscle tone Aches and pains in bones, joints and muscles Skin problems, neurological problems Hormonal abnormalities Headaches Frequent infections Allergies Anemia Urinary problems Infertility Mood alterations Memory and cognitive problems Behavioral and social problems Sleep problems Psychotic symptoms Panic attacks Anxiety Involuntary movements Tics and fits Obsessions Compulsions Eating problems Medical Diagnosis IBS, IBD, Gastritis, Colitis, Esophagitis, Celiacs, Crohns, etc. Autoimmune Disorders: MS, RA, DM1, Lupus, Psoriasis, Alopecia, PANS/PANDAS etc. ME, Fibromyalgia, Chronic Fatigue Allergies, Asthma, Eczema, Hay Fever Endocrine disorders: Thyroid, Adrenal, PMS, etc Migraines, Neuropathy, other neurological conditions Chronic Cystitis, Nephropathy Food intolerances, FPIES Autism ADD/ADHD Dyslexia Dyspraxia Learning disorders Epilepsy Substance Abuse Depression Eating disorders OCD Manic-Depressive Schizophrenia Hormone QuestionnairesAMS Checklist - BEFORE HRTCheck for EACH symptom you are currently experiencing. Decline in your feeling of general well-being Joint pain and muscular ache Excessive sweating Sleep problems Increased need for sleep, often feeling tired Irritability Nervousness Anxiety Physical exhaustion / lacking vitality Decrease in muscular strength Depressive mood Feeling that you have passed your peak Feeling burnt out, having hit rock-bottom Decrease in beard growth Decrease in ability/frequency to perform sexually Decrease in the number of morning erections Decrease in sexual desire/libido MRS Checklist - BEFORE HRTCheck for EACH symptom you are currently experiencing. Hot flashes, sweating Heart discomfort Sleep problems Depressive mood Irritability Anxiety Physical and mental exhaustion Sexual problems Bladder problems Dryness of vagina Joint and muscular discomfort Message* Δ
