Drainage Self-Assessment Questionnaire

Drainage Self-Assessment

Answer all questions honestly for best results. You will recieve an email with your score upon completion.
Please provide your contact details for more information.

By completing the quiz and inputting your information below, you consent to having your information shared with Recreated Health. You will also opt-in to our email list. This tool does not provide medical advice It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment.
Name*

First NameLast Name
Email*
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Phone Number*
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Section 1: Do you experience any of the following?

We invite you to rate the frequency of each symptom you experience, providing a comprehensive tool to track and discuss your symptoms.
Constipation (pooping one or fewer time daily)?*
Feel like your bowels do not completely empty?*
General or Chronic Fatigue? *
Wake up tired regardless of sleep?*
Anxiety, depression, or bipolar?*
Have lethargy and apathy (disinterest)?*
Memory issues, along with word or name recall?*
Brain fog or focus issues?*
Chronic inflammation in the body?*
Cellulite or flabby skin?*
Varicose or spider veins?*
Morning stiffness?*
Swollen glands or lymph nodes?*
Puffy eyes?*
Edema, swelling, or retaining extra fluid?*
Tender or swollen breast tissue?*
Wake up between 1am and 4am?*
Skin issues (acne, rashes, hives, eczema)?*
Skin doesn't sweat?*
Yellow skin or face?*
Kidney problems?*
Suppressed immune response?*
Frequent colds, flu, or sore throat?*
Trouble healing from infections, recurring? *
Heart palpitation or irregular heartbeat?*
Breathing or lung problems? *
Light, sound, or EMF sensitivities? *
Headaches/migraines? *
Loss of appetite?*

Drainage Self-Assessment

Please provide your contact details for more information.

Section 1: Do you experience any of the following?

Results

If you scored 21 or more

If you scored between 11 and 20

If you scored between 0 and 10