Your Digestion Checklist
Be as honest as you can, this is for you to help you figure out what is most important for you.


How is the Air you are Breathing?

Circle One

Yes / No / ??      -    use candles or wax regularly

Yes / No / ??      -    use air freshener or scented plug-ins regularly

Yes / No / ??      -    never open my windows

Yes / No / ??      -    live in a town that monitors the air quality

Yes / No / ??      -    work in a place where you are exposed to air pollution

Yes / No / ??      -    exercise regularly in a place near car exhaust

 Comments / Realizations:  ______________________________________________________________________________________________________________________________________________

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What about your Water?

True  or Sometimes  or Never  -  I always drink filtered water

True  or Sometimes  or Never  -  I always drink enough water

Comments / Realizations:  ______________________________________________________________________________________________________________________________________________

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What kind of Foods are you Eating?

This is my life  or  Mostly  or  once in awhile  or NEVER  -  I eat out or take out
This is my life  or  Mostly  or  once in awhile  or NEVER  -  I eat food from the grocery store and from a box
This is my life  or  Mostly  or  once in awhile  or NEVER  -  I eat food from local growers and producers
This is my life  or  Mostly  or  once in awhile  or NEVER  -  I drink soft drinks and/or energy drinks
This is my life  or  Mostly  or  once in awhile  or NEVER  -  I try every new diet fad out there
I eat ( 1 2 3 4 5 6 7 8 or more) meals or snacks a day  or I never stop eating.

Comments / Realizations:  ______________________________________________________________________________________________________________________________________________

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What are you putting on your skin? Personal Health Products - write down for just one day and read the label if you can find it

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What is your regular exercise routine in an average week? (it is okay to right none if that is what you are doing)

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List the yucky stuff going on in your body that you are not happy about. Write it down even if it has been going on your whole life or just the past few months. 

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As you review your checklist, what is the ONE THING you would like to be better? (This is what you will email to Dawn)

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