3 Minute Qualification Quiz

Lost your keys one too many times or can't recall things as quickly?

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

Are you currently being treated by a Doctor? *

Yes

Are you currently taking medications?

Yes

Do you often forget recent conversations, events, or appointments, even after being reminded? *

Yes

Do you find it difficult to remember familiar names, places, or words during conversation? *

Yes

Have you noticed trouble following instructions, recipes, or step-by-step tasks you used to manage easily? *

Yes

Do you lose track of time, dates, or where you are more often than before? *

Yes

Do you misplace everyday items (keys, glasses, phone) and struggle to retrace your steps to find them? *

Yes

Have family or friends noticed changes in your memory, thinking, or ability to concentrate? *

Yes

Have you experienced sudden mood changes, confusion, or increased frustration when tasks feel challenging? *

Yes

Have you experienced difficulty judging distance, recognizing familiar faces, or navigating familiar places? *

Yes

What are you most concerned with? *

Brain Fog

Forgetting Names

Better Sleep

Memory Recall

Enhanced Learning

Reduce Stress

How long have these been a concern?

Less than 6 months

Under 1 year

Over 1 year

What is your motivation level?

I am not worried

I am not sure

I am ready to make changes

Knowing your age will help us identify the best protocol for you.

Date of birth

Do you eat a lot of processed foods and sugary drinks?

Yes

Are you willing to change your diet?

Yes

Naturopathy, also known as naturopathic medicine, is a distinct system of healthcare that emphasizes supporting health and well-being through natural methods.

Nothing is fixed over-night. Most real solutions will take between 30-45 days before you see verifiable results.

Are you prepared to commit 45 days?

Yes

While we are processing your results, let us know where you would like them sent to?

First Name

Last Name

Email *

Phone *

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