Name:
Email Address:
YOU ARE WHAT YOU EAT: Do you shop for food less frequently than every four days
Do you eat more packaged (frozen or canned) fruit and veg than fresh
Do you eat more cooked vegetables than raw
Do you eat veg with fewer than 2 meals a day
Do you buy more non-organic veg than organic veg
How often do you use a microwave
Do you eat white bread more often than whole grains
Do you eat quick cook grains more than slow cook organic grains
How often to you consume pasteurised milk or cheese
How often do you eat non organic yoghurts
Do you eat cage raised chicken eggs
Do you eat red meat more often than every 4 days
Do you eat meats other than free range
Do you eat canned fish more than fresh fish
How often do you use commercial salad dressings
How often do you use products containing hydrogenated oils
Do you eat nuts that are roasted or salted
How often do you use sugar
How often do you use artificial sweetener
Do you use table salt
Do you eat processed foods more than 3 times week
How often do you eat fast foods
How often do you eat food from vending machines
Do you drink tap water
How often do you eat biscuits and desserts
STRESS: Do you eat more or less when stressed than when not stressed
Do you worry over job income or money problems
Are any of your relationships causing you stress
Do you often feel anxious
Do you often get upset when things go wrong
Do you lash out at others
Do you feel your sex drive is lower than normal for you
Do you feel isolated or lonely
Do you feel stressed due to lack of intimacy in one or more relationships
Are you feeling anti social
Do you take any form of prescribed medication related to stress or psychological disorders
Do you commonly lose more than 2 days of work a year due to illness
SLEEP: Do you live in the same time zone you were born in
Do you travel across time zones more than once a month
How often do you wake up feeling un rested and in need of more sleep
Do you commonly go to bed after 10.30pm
Are the times of your bowel movements consistent and predictable on a daily basis
Do you suffer from reduced memory since moving to a new time zone or since travelling across time zones
Has your sense of hunger changed since you moved to a new time zone
How often do you wake up between 1 and 4 am and not get back to sleep
How often do you tend to have a hard time staying awake in the afternoon after lunch
Do you do shift work that requires you to stay up late at night
YOU ARE WHEN YOU EAT: Do you frequently skip meals
How often do you go more than 4 hours without eating
How often do you skip breakfast
Do you avoid fats when eating
Do you frequently eat carbohydrates by themselves
Do you get hungry of crave sweets within 2 hours of eating a meal
How often do you consume drinks that contain caffeine and sugar
Have you tried diets to lose weight
Do you have difficulty burning fat around your belly hips or thighs even with exercise
Do you eat your largest meal in the evening
DIGESTION: How often do you experience abdominal bloating
Do you frequently have loose stools or diarrhoea
How often do you experience constipation or stools that are compact/hard to pass
Do you find that you often burp after meals
Do you often have gas
Do you crave certain foods such as bread chocolate certain fruit and red meat if you have not had them in a few days
How often do you have a poor appetite e or feel worse after eating
Do you have sweet cravings
Do you often experience abdominal pain cramps or discomfort (more than twice a week)
How often do you have indigestion, heart burn or an upset stomach
How often do you get a headache after eating
FUNGUS AND PARASITE: SHave you ever had general anaesthetic
Have you ever taken antibiotics
Have you ever been treated by medical drugs
Are your bowel movements loose hard or fowl smelling
Would you consider your life to be
Do you suffer from a digestive disorder
Do you have mercury fillings in your mouth
Do you have 2 types of metal in your mouth
Do you experience itching in the ear, nose or rectum
Do you or have you had dandruff in the past year
Do you regularly eat or drink products that contain sugar, white flour or processed dairy
Do you crave sugar if you don’t have it for more than 3 days
Do you find that regardless of how much you eat you get hungry quickly
In the past year, have you experienced athlete’s food (itching around the toes, soles or heel of the feet), jock itch or a fungal infection under a toenail (thickening of the toenail)
Do you ever get a reddening around the mouth of nose area after eating or drinking
Do you experience muscle or joint aches on a regular basis
Do you experience mood swings
Do you snack on sweets or drink coffee, soft drinks or sports drinks most days to keep your energy up
Do you suffer from any kind of skin condition
Have you ever had sex or close physical contact with anyone who you know had a fungal infection (including athletes foot, jock itch, dandruff) or parasite infection
Please tick your requirements
Telephone number (if you would like us to contact you by telephone)
The following questionnaire evaluates your overall health and results are displayed in a easy to view graph. (view Jody's latest health graph, aka. Chi score, by clicking on image right...) If you have taken the test before and just want an update, you can might find it use full to take the test at chekconnect.com for instant results.