Organic Herbal Colon Cleanse Australia
Customer Support Call 0423 644 495

Parasites Questionnaire

Listed in this questionnaire are symptoms. Your answer comes up at the top of the page when you have finished.

A= symptom never occur
B= symptom occur occasionally
C= symptom occur often
D= symptom occur most of the time
Total Score (A + B + C + D) =
Name A B C D
1.Chronic Fatigue?
2.Unexplained Weight Loss?
3.Always Feel Hungry?
4.Eat Raw Fish?
7.Feeling sick?
8.Lower Stomach Pain?
9.Stomach Bloating?
12.Pet Owner?
13.No appetite?
14.Frequent Overseas Travel?
15.Upper Abdominal Bloating?
17.Intermittent Constipation and Diarrhea?
18.Abdominal Cramps or Pain?
19.Inflammatory Bowel Disease (IBD)?
20.Drinking Tank Water?
22.Food Intolerances?
23.Previous Parasitic Infections?
24.Intestinal Yeast Growth (Candida)
25.Travelled in tropical or subtropical regions of the world?
26.Body Aches - Flu Like symptoms?
27.Headaches or Migraine?
28.Painful eyes reduced vision, blurred vision?
29.Sore Throat?
30.Gastrointestinal problems