Environmental Quiz

1

1. Do you drink pop, calorie free or sugary drinks?* This field is required.

YES

NO

2

Do you drink anything out of a plastic bottle?* This field is required.

YES

NO

3

2. Do you use non-stick frying pans?* This field is required.

YES

NO

4

3. Do you drink Vitamin mineral or Gatorade water?* This field is required.

YES

NO

5

4. Do you use a microwave?* This field is required.

YES

NO

6

5. Do you use a cell phone or a computer for more than 3 hours a day?* This field is required.

YES

NO

7

6. Do you use Advil, Tylenol, Immodium or any over the counter medication more than 1x/year?* This field is required.

YES

NO

8

7. Do you eat foods that have food coloring (e.g. Smarties, M&Ms, cheddar cheese, etc.)?* This field is required.

YES

NO

9

8. Do you consume canned goods (e.g. soup in a can)?* This field is required.

YES

NO

10

9. Do you use personal care products with phthalates or parabens?* This field is required.

YES

NO

11

10. Do you drink more than 2 alcoholic drinks per day?* This field is required.

YES

NO

12

11. Do you exercise less than 30 minutes per day, 4 days per week?* This field is required.

YES

NO

13

12. Do you regularly consume genetically modified foods (Corn, Soybeans, Canola, Cottonseed, Beet sugar)?* This field is required.

YES

NO

14

13. Do you eat any of the following foods in non-organic form: Apples, Celery, Cherry tomatoes, Cucumbers, Grapes, Hot peppers, Nectarines (imported), Peaches, Potatoes, Spinach, Strawberries, Sweet bell peppers* This field is required.

YES

NO

15

14. Do you drink manufactured orange juice?* This field is required.

YES

NO

16

15. Do you suffer from ongoing fatigue, headaches, pain, or constant colds and coughs?* This field is required.

YES

NO

17

16. Do you regularly experience digestive concerns (gas, bloating, constipation, diarrhea, IBS)?* This field is required.

YES

NO

18

17. Have you been diagnosed with low thyroid function or a skin condition (eczema, psoriasis, acne)?* This field is required.

YES

NO

19

18. Do you use hand sanitizer or Colgate toothpaste regularly?* This field is required.

YES

NO

20

19. Are you more than 15 lbs overweight?* This field is required.

YES

NO

21

20 Do you use perfume?* This field is required.

YES

NO

22

Calculation

23

Result 1 (Score < 5)
🎉 You win top marks and qualify for the ‘Squeaky Clean’ award – Congratulations!”

24

Result 2 (Score 5 - 12)
⚠️ You are in need of an integrated detoxification program – call our clinic at 587-521-3595 to schedule an appointment with Dr. Michael Mason-Wood.

25

Result 3 (Score > 12)
❗ Your body is a toxic wasteland – call our clinic today to schedule a critical care appointment with Dr. Michael Mason-Wood, 587-521-3595.