Functional Diagnostics Symptoms Questionnaire

This questionnaire can be used as a baseline for symptoms and analyzing underlying issues.

It is important to understand that this should only used as a aid to guide further testing which could include laboratory testing.

Click to download questionnaire form in Apple Numbers format (can be loaded in Microsoft Excel) FDquestions

After completing the questionnaire, the scoring sheet below can be used areas of priority that may need to be addressed.

 

 

References:

  1. Nutritional Therapy Association.
  2. Richard C. Weatherby, ND and NTA.