Oligoscan

Oligoscan Pre-Test Questionnaire

Name

First NameLast Name

Date

Date of Birth

Date

Age

Gender

Weight

Height

Blood Type

If you don't know your blood type for sure, we have an instant test available for $15.

Hand Dominance

How many hours of sleep do you get per night?

How is the quality of your sleep?

Symptoms/Complaints?

Special diet? (Raw, Vegan, Vegetarian, Organic, Carnivore, Keto, Fasting, etc)

Do you eat Chocolate? If so, how much & what frequency?

Chocolate is one of the highest sources of Cadmium & Lead of all processed foods.

Drinking Water (Municipal/tap, well, bottled, filtered, etc)

Plastic Bottles contain Antimony. Most Municipal water contains Fluoride, Aluminum, and other toxins.

Describe your daily perspiration (sweating) while WALKING

Describe in both average # of minutes & relative sweat scale 1-10 (1 for none and 10 for highest)

Describe your daily perspiration (sweating) while EXERCISING

Describe in both average # of minutes & relative sweat scale 1-10 (1 for none and 10 for highest)

Describe your daily perspiration (sweating) from a SAUNA

Describe in both average # of minutes & relative sweat scale 1-10 (1 for none and 10 for highest)

Alcohol (types & frequency/week)

Smoking (including Vapes, types & frequency/week)

Tattoos (# and location)

Residence - City/Country & Postal Code

Do you live in a Metropolitan Area?

Proximity to Airports, highways, industrial mfg., refineries, smelter plants, etc?

Air, water, and soil can be contaminated by fuel exhaust (car & airplane), fuel spills into water supplies and food sources.

Occupation/Work Exposure (working with metals, chemicals, dyes, paints, petroleum)

Overall Stress Level (Scale 1 10, 1 for minimal stress, 10 for very stressed)

Have you had COVID?

If so, how many times?

Covid 19 Vaccination?

# Vaccinations as a child?

# Flu Vaccinations?

Activities/Hobbies (Including paints, welding, metal working, inks containing heavy metals, golf courses, chlorine swimming pools, etc.)

List all medications (ex: Aspirin, Cholesterol, Heart, Acid Reflux, SSRIs, etc) you are taking.

May contain coloring agents, aluminum, titanium, mercury, etc.

List all supplements you take.

If the body is not absorbing the supplements, this will be indicated on the Oligoscan.

List all Minerals you take.

Minerals can be depleted by heavy metals and will show up as low on the Oligoscan even when supplemented.

Do you take hormones? (ex: Birth control, IUD, HRT, Bioidentical, HcG Topical or Oral, etc)

Disrupts the natural function of the body and creates dependencies. May have artificial ingredients not recognized by the body.

Do you take Zeolite or Oral Chelators, EDTA, DMSA? (list)

Topical Chelators, Ionic Foot Baths, Herbalix Topicals? (list)

Internal detoxing is not effective if the person is a non-excreter and the lymphatic system is blocked.

Dental Work? (Amalgam, Caps, Bridges, Root Canals, etc.)

Source of Heavy Metal exposure, particularly Mercury, Silver & Aluminum.

Cosmetics, Anti Perspirant Deodorants (list)

Contain non-beneficial ingredients including aluminum, which can be toxic. Note: It is important to allow the body to perspire without interruption. The wetness and odors can be controlled with natural, non-suppressing deodorants and will be minimized over time.

Do you regularly wear a smartwatch, Whoop, Oura Ring, Airpods, etc.?

Potential EMF source & lithium exposure from batteries

Do you have WIFI? Sleep with it on? Sleep next to your phone? (Describe)

EMF exposure can increase Magnesium burn rate and alter Sodium/Potassium voltage gated channels.

WOMEN ONLY - When was your last period?

WOMEN ONLY - When was your last pregnancy?

WOMEN ONLY - Are you breastfeeding?

There may be some depletions such as hormones and/or minerals if pregnant or recently had a baby.

Recent Medical Tests? (ex: Mammogram, CAT, MRI, X Ray, Colonoscopy, etc)

Can be disruptive to the body and can introduce radiation, irritation to tissues (contrast agents - Gadolinium)

Family History / Concerns

Surgeries? (ex: joint replacements, implants, screws, etc)

Source of heavy metal exposure/blockages

Any accidents or injuries?

Can create lymphatic blockages due to restrictions from scars, surgeries, etc.

Other observations (i.e. country of origin, recently relocated from, etc)

Moving to another part of the country or world may expose you to different parasites, bacteria, viruses, toxins, etc. Also, the types of food available to you may have changes. Your heritage and genes should be considered.