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  • This will be a video to explain how to complete the form.

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  • We believe in the power of vine-ripened, organic fruits, vegetables and whole grains. Would you be interested to learn about a whole food concentrate available in tasty gummies or capsules with over 30 clinical research studies proving it works at the cellular level?

  • Conditions and Complaints Client and doctor

  • There are 282 conditions listed below. Choose only the conditions that you would like to work on in the next 30 to 60 days. As your body begins to heal you should complete another questionnaire for a greater variety of food choices. 

    Keep in mind, the more conditions you select, the more limited your therapeutic food list will be.

  • Organs and Systems Client and Doctor

  • Click on the organs and systems you wish to give additional nutritional support. However, you do not have to choose anything.

  • Toxins and Junk Food Client and doctor

  • It is not necessary to choose any option below. If you would like more information, however, use your mouse and hover over an option to learn more.

  • Food Component Reactions client and doctor

  • Typical Blood Type Allergens Doctor Forms

  • Rh Factor Allergens Doctor

  • Gender Specific Allergens Doctor

  • Blood Type Lectin Reactions Doctor

  • Vegetarian and Ethnic Intolerances _ Both Forms

  • Macronutrients Clients and Doctors

  • Advanced Nutritional Options

  • Micronutrients Doctor Form Only

  • Minerals Doctor Form Only

  • Essential Amino Acids

  • Non-Essential Amino Acids

  • Fatty Acids

  • Specific Unsaturated Fatty Acids 

  • Omega 3

  • Omega 6

  • Omega 9

  • Specific Saturated Fatty Acids

  • Diet Therapies (Doctor and Client Forms)

  • Metabolic Types 

  • Metabolic Modifiers

  • Endocrine Types

  • Ayurvedic Types

  • TCM Food Qualities

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  • Specific Foods (Doctor Only)

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  • Thank you for completing this form. Your confidential therapeutic food list will be emailed to you within 24 hours. We appreciate the opportunity to serve you.

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