Are you vegetarian or vegan? *

Yes

No

Do you know your Vitamin D level? *

Yes

No

Do you have trouble tolerating gluten or dairy? *

Yes

No

Do you get abdominal pain or bloating? *

Yes

No

Do certain foods trigger your migraines? *

Yes

No

Do you have brain fog or fatigue? *

Yes

No

Do you have mercury fillings? *

Yes

No

Do you eat organic fruits and vegetables? *

Yes

No

Do you usually sleep 7-8 hours a night with no major interruptions? *

Yes

No

Do you tend to get migraines before your period? *

Yes

No

How have your stress levels been in the past 3-6 months? *

High

Low

First Name *

Email *

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