Have you lived near a farming community at any stage of your life? *

Yes

No

Have you spent a lot of time swimming in open water? *

Yes

No

Do you spend most of your time indoors? *

Yes

No

Do you drink out of plastic container? *

Yes

No

Do you cook with nonstick surfaces? *

Yes

No

How often do you choose organic fresh or frozen vegetables? *

Very Often

Not Often

Do you buy grooming products from EWG? *

Yes

No

Do you have to use a lot of bug spray, sunscreen or conventional beauty product? *

Yes

No

Do you drink enough water? *

Yes

No

Do you feel constipated? *

Yes

No

Do you exercise? *

Yes

No

Have you ever had a major illness like lyme or cancer? *

Yes

No

Do you have NAFLD? *

Yes

No

Are your liver enzymes every elevated on your labs? *

Yes

No

First Name

Last Name *

Email *

Phone *

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