Gut Health Consultation Intake
Please complete this intake upon scheduling your appointment. Your GI MAP test will not be ordered until this is submitted.
Have you had frequent illnesses in the past requiring antibiotics?*
Which of the following symptoms do you struggle with?
Do you feel rested when you wake up in the mornings?*
Have you ever been formally diagnosed with an eating disorder?*
Are you currently following any of the following dietary restrictions?
What would you consider your current weekly exercise routine?