Questionnaire

Last updated: May 8th, 2008

PLEASE NOTE: Normally we are closed on the weekends only, but in the spring / summer of 2008 the office will be staffed Mondays -Thursdays, with three- weekends frequent. You are welcome to fill out the questionnaire and make payment during these long weekends, but may not hear back from us until Monday mornings. If you complete the questionnaire prior to Thursday evening, you should receive an email acknowledgement from us before the extended weekend begins. Everything should work smoothly for you anytime you are filling out the questionnaire.

Thank you for your patience.

Before you begin...

	If you wish to remain completely anonymous, you may use a false name and any (working) e-mail address.  The e-mail address must be valid since that is how we send your report.
	Your report can be password-protected so that no one else can read it.

NONE of this information will EVER be given to third parties.
Items marked '*' are mandatory.

Your name: * First, Middle Initial(s), Last
Date of birth: * MM-DD-YYYY
Sex: *	Male   Female
Your e-mail address: * Please check it carefully!	You will have the option to receive a password-protected report so that only you can read it.

CUSTOMIZE YOUR REPORT The report that you receive will be very detailed.  In order to keep its size down to a minimum, you may wish to select only those options below that are of interest to you. (These options also determine which questions you will be asked.)	Include
Conditions that you are already aware of Would you like to read what we have to say about conditions that you tell us you have? This should always be checked unless you are certain you DO NOT wish to receive information on conditions of which you may already be aware.
Metabolic Typing Would you like custom diet and nutrient recommendations based upon our calculations of your metabolic type?
Recommendations based on your blood type Would you like to see information based upon the book by Peter D'Adamo, ND?
Ayurvedic Typing Would you like some basic recommendations based on this 4,000 year-old traditional Indian system?