Customized Wellness Protocol Recommendation

Please answer the questions below and I will send you a customized wellness protocol.

What specific health concerns are you wanting to address?*

In the past 12 months, which of the following symptoms have you experienced? (Check all that apply.)

Brain Fog

Hormone Imbalance

Sleep Issues

Weight Loss Resistance

Digestive Issues

Anxiety

Depression

Mood Swings

Low energy or Fatigue

Skin Rashes

Food Sensitivities

Chronic Headaches

Low Stress Resilience

Chronic Inflammation

Poor Immune Function (Either under active "always sick" or overactive "autoimmune issues"

Other

Which of the following BEST describes your current nutrition?

Mostly processed foods, eat out a lot.

Somewhat clean, some processed foods & some eating out.

Mostly clean, rarely eat processed foods & occasional eating out.

Are you currently on any medications or have you taken any prescription medications in the previous years? (Including hormonal birth control.

Yes

Anything else you believe would be important to know?

What is the best way for me to contact you with your wellness protocol?

Text

Facebook Messenger

Instagram DM's

Phone

If Facebook/Instagram is your preferred use of communication drop your URL here.

Peace - Love - Hope

Haman's Homestead LLC

Dunlap, TN 37327

Contact me by Email Text