Immune Review Survey

  • Enter your numerical score per section, then add each to find your total score. (Bottom of Survey)

  • 0: I rarely if ever feel stressed
    1: I have a lot on my mind but I can manage it
    2: I have some days that just feel like too much
    3: I am in a constant state of feeling overwhelmed
  • 0: I wake up feeling rested in the morning
    1: I have difficulty falling or staying asleep
    2: I wake up tired even after 6 or more hours of sleep
    3: I struggle with insomnia
  • 0: I enjoy physical activity, and this is part of my regular routine
    1: I do not exercise but walking, lifting, or climbing stairs is no trouble
    2: I avoid walking, lifting, or climbing stairs due to physical difficulty
    3: I am unable to walk, lift, or climb stairs unless physically assisted
  • 0: I eat mostly organic, unprocessed foods daily
    1: I try to eat fruits and vegetables every day
    2: I eat mostly meat and potatoes and enjoy wine or other alcohol daily
    3: I eat mostly fast food meals, salty snacks, and sugary desserts daily
  • 0: I take multiple vitamins and supplements daily
    1: I take a multivitamin plus one other supplement daily
    2: I take one multivitamin a day
    3: I take no supplements or vitamins
  • 0: I know my vitamin D level and it is in range
    1: I was never told my Vitamin D level was low
    2: I have had a low Vitamin D level before
    3: Unknown
  • 0: I have never smoked
    1: I was exposed to second hand smoking
    2: I am a former smoker
    3: I am currently smoking or vaping
  • 0: I take no prescription medication
    1: I take one prescription medication daily
    2: I take two prescription medications daily
    3: I take three or more prescription medications daily
  • 0: I have no health issues
    1: I have diabetes and/or heart disease
    2: I have high blood pressure
    3: I have a combination of these and/or other health issues
  • 0: I live in and work in a healthy environment without exposure to toxins or illness
    1: I have one healthy environment but could be exposed to toxins or illness in the other
    2: I both live and work in environments that could expose me to toxins or illness
    3: I know I am being exposed to toxins or illness in one or both environments
  • Scoring:
    0-5 = Strong immune
    5-10= Pretty good immune
    10-20= Needs some improvement
    20-30 = Needs much improvement
  • *To get your results and suggestions, enter your name, phone number and email address. You will receive a personalized response in regards to the Survey within 24 hours.