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Leaky Gut Quiz
1
"LEAKY GUT" Quiz
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2
Do you have alternating constipation and diarrhea?
1
2
3
4
5
Never
alway
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3
Do you have constipation?
1
2
3
4
5
Not at all
Definitely
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4
Do you have aches, pains, and swelling throughout the body?
1
2
3
4
5
Not at all
Definitely
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5
Do you have diarrhea?
1
2
3
4
5
not at all
Definitely
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6
Do you have unpredictable abdominal swelling?
1
2
3
4
5
Not at all
Definitely
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7
Are you frequently bloated and distended after eating?
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1
2
3
4
5
Not at all
Definitely
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8
Do you have chronic Fatigue?
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2
3
4
5
Not at all
Definitely
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9
Do you have brain Fog?
1
2
3
4
5
Not at all
Definitely
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10
score
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11
Your Score Is {typeA}/40
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12
Based on your assessment you have "Leaky Gut"
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13
Are you looking for a new approach to your health?
*
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Yes
No
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14
Name
First Name
Last Name
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15
Where should we send the results?
example@example.com
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16
Phone Number
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Area Code
Phone Number
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