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?*