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Food and Beverage Toxicity Survey - Do you
consume any of the following frequently?
- Non-organic or decaffeinated tea or coffee
- Artificial sweeteners
- MSG
- Sodas
- Processed or convenience foods
- Non-organic fruit without washing or peeling
- Smoked foods such as bacon, ham, fish, cheese, cold cuts
- Processed meats, such as sausages, burgers
- Fried foods
- Excessive alcohol
- White bread, pasta, rice
- Non-organic leafy vegetables without washing and removing outer
leaves
- Non-organic root vegetables without scrubbing and peeling
- Foods with preservatives, additives, and texturizers
Environmental Toxicity Survey - Do you
frequently use or are you regularly exposed to
- Pesticides, herbicides, or fungicides or live near fields that are sprayed
- Drink chlorinated water or swim in chlorinated pools
- Live or work in an older building that has lead based paint
- Your house recently been repainted
- Exhaust fumes while walking or running near a busy road
- Live in a city or near a major street or flight path
- A mobile phone
- Have your clothes dry cleaned regularly
- Synthetic air fresheners, or perfumes
- Perfumed laundry products
- Use bleach, household cleaners, detergents, disinfectants
- New home furnishings, especially those with "strain resistant"
coatings
- Work in or spend much time in clothing stores
- New carpeting or vinyl
- Fiberboard, plywood, MDF or chipboard
- Central heating or air conditioning
- Live near a power station or high voltage overhead power cables
- Cook with gas
- Work with a computer
- Smoke
Heavy Metal Survey
- Do you now have, or have you ever had, silver amalgam fillings in your
teeth? They are dark gray in color and easy to see.
- Did your mother have silver amalgam fillings during her pregnancy with
you?
- Did you receive a full course of inoculations as a child?
- Do you live in a polluted city, industrial area, or agricultural area that
uses pesticides?
- Have you ever worked in a dental office or other industry that uses heavy
metal components?
- Do you eat a lot of fresh or canned fish?
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