Mens Functional

Name(Required)
Please describe your current digestion and select the answer below that best applies to you:
Max. file size: 8 MB.
Do you own and use a smart watch that tracks total daily calories and activity? (Apple watch, fitbit, galaxy)(Required)
Please score each question with the following correlating number to the answer that most accurately describes your current status:
1) None, 2) Mild, 3) Moderate, 4) Severe, 5) Extremely Severe
Under each category below, please mark as many as you feel relate to you either currently or previously.
Category A: Please mark an “x” next to each statement you feel you identify with:(Required)
Category B: Please mark an “x” next to each statement you feel you identify with(Required)
Category C: Please mark an “x” next to each statement you feel you identify with(Required)
Name
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