COMPREHENSIVE DETOX ASSESSMENT

COMPREHENSIVE DETOX ASSESSMENT

Name
Name
First
Last

 

Welcome to SIMPLY DAWN! Below is a list of symptoms (categorized by body area) that can be indicators of a toxic overload. To assess your toxic burden and some of the associated symptoms you may be experiencing, please rate each of the following concerns based on your typical health for the past month. Total your points for each section as you go. Once completed, add section totals together to calculate your grand total.

Based on your point totals, we'll share recommendations and next steps that may be beneficial for you in addressing these symptoms.

NOTE: This assessment complements, but does not replace, primary medical care. Chronic medical conditions stem from underlying issues. This assessment is specifically meant to help identify the body's burden level for toxicity. Taking proactive health measures can help support healing, reduce symptoms, and enhance overall health. This form is secured. Your responses are confidential and used only for personalized recommendations.

**Symptoms marked with two gray asterisks may indicate a Candida or hormone-related symptom. Further screening may be needed.

 

POINT SCALE:

0 — Never or almost never occurs

1 — Occasionally occurs, effect is not severe

2 — Occasionally occurs, effect is severe

3 — Frequently occurs, effect is not severe

4 — Frequently occurs, effect is severe

HEAD

MOUTH/THROAT

EYES

SKIN

EARS

HEART

NOSE

LUNGS

DIGESTIVE TRACT

MIND

JOINTS/MUSCLES

EMOTIONS

WEIGHT

ENERGY/ACTIVITY

OTHER

GRAND TOTAL

Have you used antibiotics frequently?
Have you used hormonal contraceptives for 2+ years?
Do you have a history of chronic stress or fatigue?

(0-60) NO/LOW SYMPTOMS: (History of antibiotics, chronic stress, or long-term hormonal contraceptive use? These may suggest underlying concerns.)

General Assessment:

Minimal or no overt symptoms? Great!

Recommendations:

A seasonal cleanse is a powerful preventative health measure to support your body systems and metabolism, boost energy levels, and reset healthy habits. Because modern lifestyles expose us to toxins each and every day, we recommend completing a PaleoCleanse Plus 14-day Detox seasonally every 3-4 months as a preventative health practice for overall lifestyle maintenance.

Options:

    1. Visit our Virtual Dispensary. (Be sure to mention you saw this on our blog to receive a 20% off discount code for your cleanse kit.)
    2. Call, text, or email us with any questions you may have. We are here to support you!

(61-120) MILD TO MODERATE SYMPTOMS: (History of antibiotics, chronic stress, or long-term hormonal contraceptive use? These may suggest Candida, hormonal imbalances, or other underlying concerns.)

General Assessment:

Mild to moderate symptoms suggest a toxic load.

Recommendations:

We recommend completing a PaleoCleanse 14-day Detox (at a minimum). Possible add-ons to this cleanse include Charcoal Binder for boosting detoxification processes, and/or Metal-X-Synergy for detoxing heavy metals.

You could also benefit from booking a Wellness 360 Consultation and exploring a possible 30-day (or other) wellness program for a more complete cleanse re-set. We can help you determine the best course of action.

Options:

    1. Visit our Virtual Dispensary (Be sure to mention you saw this on our blog to receive a 20% off discount code for your cleanse kit.)
    2. Book a Wellness 360 Consultation
    3. Learn more here: Wellness Studio 360
    4. Call, text, or email us with any questions you may have. We are here to support you!

(121+) MODERATE TO SEVERE SYMPTOMS: (History of antibiotics, chronic stress, or long-term hormonal contraceptive use? These may suggest Candida, hormonal imbalances, or other underlying concerns.)

General Assessment:

Moderate to severe symptoms signal a more significant toxic load. A seasonal cleanse is foundational to start your health reset. However, a more thorough program may be necessary for a more complete re-set. Underlying conditions such as Candida or hormone imbalances may also be present.

Recommendations:

We recommend completing a PaleoCleanse 14-day Detox (at a minimum). Possible add-ons to this cleanse include Charcoal Binder for boosting detoxification processes, Metal-X-Synergy for detoxing heavy metals, and/or ProbioMed as a potent probiotic.

Depending on the extent of your symptoms, we also recommend booking a Wellness 360 Consultation where we can dial down on your specific needs, complete a Candida or Hormone Screening, look into our Spotlight functional testing options, and/or explore a more comprehensive program to get you feeling healthy, vibrant, and back on track. We can help you determine the best course of action.

Options:

    1. Visit our Virtual Dispensary. (Be sure to mention you saw this on our blog to receive a 20% off discount code for your cleanse kit.)
    2. Book a Wellness 360 Consultation
    3. Ask about our functional health Spotlight testing options for a more thorough assessment of body systems.
    4. Learn more here: Wellness Studio 360
    5. Call, text, or email us with any questions you may have. We are here to support you!