 |
|
Name:_________________ Date of first score_________ Date of second score_________ Print out this chart and score your health before taking any products. Make notes of any specific conditions and symptoms you notice. Be careful to note and rate all health concerns, no matter how minor they seem. You may want to note how long you have had a symptom or a condition, its intensity, its frequency, etc. Then, score yourself again after faithfully taking the products for 6 months. This will help you in deciding whether lifelong supplementation is a wise decision. Starting body weight_______ Also record body measurements in inches before starting. SCORING: 5=Excellent 4=Good 3=Mediocre 2=Not Too Good 1=Poor |
|---|
| SYMPTOMS | NOTES | SCORE | SCORE |
| Skin appearance | ______________________________ | ____________ | ____________ |
| Skin Tone | ______________________________ | ____________ | ____________ |
| Muscle tone | ______________________________ | ____________ | ____________ |
| Muscle to fat ratio | ______________________________ | ____________ | ____________ |
| Quality of eyes | ______________________________ | ____________ | ____________ |
| Activity level | ______________________________ | ____________ | ____________ |
| Stamina | ______________________________ | ____________ | ____________ |
| Mental attitude/Mood | ______________________________ | ____________ | ____________ |
| Flexibility of the mind | ______________________________ | ____________ | ____________ |
| Resting heart rate | ______________________________ | ____________ | ____________ |
| Active heart rate | ______________________________ | ____________ | ____________ |
| Blood pressure | ______________________________ | ____________ | ____________ |
| Respiration/Breathing | ______________________________ | ____________ | ____________ |
| Digestion | ______________________________ | ____________ | ____________ |
| Elimination | ______________________________ | ____________ | ____________ |
| Taste & smell | ______________________________ | ____________ | ____________ |
| Ear health & hearing | ______________________________ | ____________ | ____________ |
| Sleeping | ______________________________ | ____________ | ____________ |
| Energy level | ______________________________ | ____________ | ____________ |
| Finger & toe nail quality | ______________________________ | ____________ | ____________ |
| Hair condition | ______________________________ | ____________ | ____________ |
| Pinkness of tongue | ______________________________ | ____________ | ____________ |
| Health of teeth & gums | ______________________________ | ____________ | ____________ |
| Freedom from aches & pains | ______________________________ | ____________ | ____________ |
| Breath odor | ______________________________ | ____________ | ____________ |
| Body odor | ______________________________ | ____________ | ____________ |
|