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This Integrative Health and Wellness Assessment is intended for informational purposes only.  It is not a substitute for professional medical advice, diagnosis or treatment.  However, you are more than welcome to print out this form and discuss it with your physician.


Assessing our nutrition helps us obtain optimal bodily function. Through both healthy food choices and exercise, we can fool Mother Nature.


Choose the response that most closely resembles how you feels about making changes or improvements to your nutritional life 

Nutritional  Action Plan

Please list 3 changes that you can implement into your current lifestyle over the next 3 months: