MENS HEALTH CHECKLIST

Lulu Chavez

TOXIC FREE LIFE COACH

MEN'S HEALTH CHECKLIST

THANK YOU for wanting to take care of your health in a natural way.

I am proud of you for wanting to start this journey of healing from inside out.

The Wellness Assessment consists of 2 things:

1) Health Checklist below

2) ZYTO SCAN

ZYTO LINK SCAN simplifies this process by gathering key information from the body in a matter of seconds.

Get key wellness information in 30 seconds
Accurate and non-invasive
Access personalized wellness reports
Available on Android & Apple devices
Vital measurements - Heart rate, HRV, Breathing rate, Skin age, & Mental stress
180+ biomarker measurements
Biomarker responses with top products by category - Systems, Lifestyle areas, & Emotions
Top overall products and wellness services recommendations

COMPLETE YOUR ZYTO SCAN HERE

After I receive your checklist and your scan results. I will contact you to schedule your wellness assessment appointment. You will receive a video explaining your Zyto results within 48 to 72 hrs.

Name*

Email*

Phone*

Whatsapp or Telegram*

Best Method od Contact*

Age*

Address*

How did you hear from my services?*

What do you do for a living? How many hours a week do you work?*

Marital Status*

Children?*

Pets? What kind and how many?*

Height*

Current Weight*

How much did you weigh 6 months ago?*

How much did you weigh a year ago?*

Would you like to weigh less? If so, how much would you like to weigh?*

Do you get sick often? Explain*

Any Health conditions? Explain*

Have you ever been hospitalized, had a serious illness or are you under a medical treatment?*

What concerns you about your health?*

Has there been a moment or period of your life that you felt better?*

How do you sleep?*

How many hours do you sleep?*

Do you wake up during the night? If so, why?*

Do you have body pains or get swollen? If so, explain*

Do you have constipation (going to the bathroom #2 once a day or less), diarrhea or gas? explain*

Allergies or sensitive to something? Explain*

Do you take medications or supplements? Explain*

Superfoods? Explain*

Do you exercise, walk, etc? if so, how often? *

Are most of your meals made at home or eat out?*

Do you cook?*

Do you buy organic fruits and vegetables?*

Do you eat meat? How often? What Kind? Where do you buy it? *

How often do you eat out? How often do you eat fast food?*

How often do you eat junk food?*

How was your diet as a child?write an example of what you used drink, eat for breakfast, lunch, dinner and snacks*

How is your diet today ? write an example of what you drink, eat for breakfast, lunch, dinner and snacks*

Do you crave sugar? How often do you have desserts, ice cream, etc?*

Do you eat products that have artificial coloring? Explain*

Caffeine? Coffee or energy drinks? how often? how much?*

How many oz of water a day do you drink? Where does your water come from? *

Do you smoke? If so, do you want to quit?*

Do you watch the news? How often?*

Do you play video games? how often?*

Do you watch suspense, drama or scary show or movies? how often?*

Do you feel anxious, depressed, etc? how often?*

Do you sleep with your cellphone next to you?*

Has you home been flooded, had a plumbing leak or humidity smell? *

Have you been exposed to mold?*

What do you clean your home with? What detergent do you use? Do you burn candles, use room sprays? *

In your opinion, What is the most important thing or habit to change to improve your health?*