Original Base Questionnaire

  • Base & Balancer Questionnaire

  • The Sensamed Base and Balancer questionnaire can be emailed to your client.

    To send the questionnaire, enter your email and your client's email below.

    Once they have filled the questionnaire in:

    1) the client will see the recommended remedies on the final page of the questionnaire

    2) the results are emailed back to you in 2 separate emails (Base results and Balancer results)

  • Who Clicked

  • For the most accurate results, please answer each question.

  • Section 1 - Do you experience any of the following:

  • Rows
  • Rows

  • Section 2 - Do you experience any of the following:

  • Rows
  • Rows

  • Section 3 - Do you experience any of the following:

  • Rows
  • Rows

  • Section 4 - Do you experience any of the following:

  • Rows
  • Rows

  • Section 5 - Do you experience any of the following:

  • Rows
  • Rows

  • Section 6 - Do you experience any of the following:

  • Rows
  • Rows

  • Section 7 - Do you experience any of the following:

  • Rows
  • Rows
  • Should be Empty: