Questionnaire

Questionaire
First
Please indicate whether you suffer from any of the symptoms below
Have you consulted a Doctor about your conditions?

I understand that the test I am about to undertake is NOT A MEDICAL TEST NOR DOES IT FORM PART OF ANY MEDICAL DIAGNOSIS. It is a simple food test by an intolerance therapist to try and pin point potential foods that may be causing a health issue. I understand that this has an accuracy of between 75-80% and in order to fully complete the program I must eliminate the suggested foods to see if they are in fact causing a problem. I agree to undertake any advice as a result of this test of my own free will.

I do / do not give my consent for future correspondence by:

how can we help you?

Complete our Questionnaire to see how we can help you

Do you suffer with?….

Bloating, Ibs, Fatigue, Ibs, Irregular periods, Hormone swings, Mood swings, Dry skin, Eczsma, Intolerant, Tired, Stress, Stressed, Irrational, Trying to lose weight, Impatient, Swelling, Lack of energy , Miserable, Unhappy, Anti depressants, Behavioural issues, Lack of ability to focus, Memory loss, Brain fog, Achey joints, Arthritis, Rheumatoid arthritis, Cravings, Low sugar levels, Palpations, Anxiety, Depression, Feeling low, Acne, Bad eating habits, Lack of sexual interest, Low libido, Lack of attention, Sugar rush, Sugar hit, 11 o clock sugar crash

“I don’t get any stomach pain now, have more energy & I’m losing weight”
I went to Phillippa as I was suffering terribly with my stomach. After she did the testing it became apparent that I was wheat intolerant. I have since given up wheat in my diet and I feel amazing! I don’t get any pains, I’m losing weight and I also have so much more energy than before. Thank you so much you’ve definitely changed my life as my “IBS” symptoms were controlling me.

Rebecca, Chatham