Check off which problem/s you are experiencing
On a scale of 1-10, one being hardly any pain and ten being unbearable, how would you rate your pain?
Please Describe your Pain/Discomfort
Diarrhea or Constipation
I feel tired after I eat
I crave certain foods
How long have you had this problem? *
Over 3 Years
How many doctors have you seen for this problem?
What have you tried in the past to correct the problem?
Over The Counter (Pepto Bismol, Antiacids, Laxatives)
Surgery (Thyroid Removal, Gall bladder Removal)
Natural Alternatives (Essential Oils, Tea, etc
Do any of these apply to you?
I can't enjoy certain foods
I can't fall asleep
Constantly having to go to the bathroom
I can't remember things as well
Irritable if meals are missed
What areas of your life are being negatively impacted?
Ability to Exercise
On a scale of 0 - 5 how important is it for you to get this problem corrected?
Is there anything else you’d like to share with us regarding your goals?
Congrats, you qualify for a $109 Digestive Consultation and Exam! What time of day is it best to reach out to you to book?