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Home
Working with me
Courses
Become A Specialist
Short Courses
Vondas Picks
Blog
Media
Contact
Sign In
My Account
Name
*
First Name
Last Name
Email Address
*
General Indicators
Rate each symptom on a scale from 0-4; 0 being no symptom, 4 being severe
Mental/emotional functioning
Depression
0
1
2
3
4
Feel spacey, light-headed, or disoriented
0
1
2
3
4
Poor memory
0
1
2
3
4
Inability to make decisions and to concentrate
0
1
2
3
4
Digestive Symptoms
Bloating, distension, or gas
0
1
2
3
4
Abdominal pain
0
1
2
3
4
Reproductive System
Loss of sexual interest or ability
0
1
2
3
4
Troublesome vaginal burning, itching, or discharge
0
1
2
3
4
Premenstrual tension or cramps
0
1
2
3
4
Muscles and Joints
Cold hands or feet or physical chilliness
0
1
2
3
4
Pain or swelling in joints
0
1
2
3
4
The Most Indicative Symptoms
Chronic eczema, rashes, or itching (e.g., anal, under breasts)
0
1
2
3
4
Body odor or bad breath not relieved by washing/brushing
0
1
2
3
4
Chronic sore throat, laryngitis, cough, or tender glands
0
1
2
3
4
Urinary frequency, burning, or urgency
0
1
2
3
4
Pain or tightness in chest, wheezing, or shortness of breath
0
1
2
3
4
Recurrent ear infections, fluid in ears
0
1
2
3
4
Chronic sinus infections
0
1
2
3
4
Food sensitivity or intolerance
0
1
2
3
4
Major Influences - Personal History
Check all that apply
Antibiotics and Drugs as Factors
Have you taken tetracycline or other antibiotics for one month or longer?
Have you taken frequent short courses of other broad-spectrum antibiotics?
Have you taken prednisone or other cortisone-type drugs for one month or more?
Have you taken birth control pills for more than a year?
Key Symptoms
Have you had persistent yeast infections, prostatitis, vaginitis, or other reproductive problems?
Have you been frequently exposed to high-mold environments and seemed to have a sensitivity to mold?
Have you had severe athlete's foot, nail or skin fungus, ring-worm, or other chronic fungus?
Have you been treated for internal parasites?
Cravings
Do you crave or consume lots of sweets?
Do you crave or consume lots of starches, such a pasta or bread?
Do you crave or consume lots of alcoholic beverages?
Thank you! We will follow up with you about your results shortly.
