• Consultations

    As Christian health educators, we offer health and nutritional counseling for individuals
    dealing with various health conditions, including:

    For only $125 this service has proved educational for many searching for wholeness. If you desire assistance with your health concerns, please complete the consultation form and submit it with any additional information (laboratory, imaging, etc.) that may be helpful.

    This health and nutrition evaluation is intended for educational purposes only, to assist the individual in learning how to preserve their own health. It is not the intention of this evaluation to diagnose or to prescribe any medication, treatment or modality for any physical or mental disorder, disease, ailment, complaint or anomaly. Therefore any use of the information obtained from this health and nutritional evaluation, is at the sole discretion of, and in response to the direct request made by the individual whose name is signed on the form.

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  • HEALTH AND NUTRITION EVALUATION

    Providing the following information will allow a better understanding of your condition, and enable us to help you more. Explain fully where necessary.

    HEALTH AND NUTRITION EVALUATION FORM HEALTH AND NUTRITION EVALUATION FORM (37 KB)

    1. Your first name
      Your last name
    2. Street address
      Apartment, suite, unite etc.
      Country
      City
      State / Province / Region (if applicable)
      Postal code / Zipcode
      Home Phone
      Cell Phone
      Email Address
    3. Birth Date
      Birth Place
      Nationality
    4. Marital Status
    5. Sex
      Height
      Weight
      Religious Preference
    6. MEDICAL HISTORY

    7. Give medical history - names and dates of past ailments, operations (anything you feel significant, including past complaints).
      When did you last consult a physician?
      For what reason?
      What are you currently being treated for?
      What specific conditions would you like this consultation to address?
      List all medicine, pills, or drugs you are taking now
      List mineral and/or vitamin supplements you are taking/how many and how often
      Do you have indigestion?
      Gas?
      Bloating?
      How Often?
      What foods tend to cause indigestion, bloating or gas?
      How often do you have bowel evacuations?
      Color & Texture
      Do you have Diarrhea?
      Constipation?
      What color is your urine usually?
      Do you wear eyeglasses?
      Contact lenses?
      How many years?
      What health ailments, illnesses or challenges have you suffered with in the past and/or are currently
      sufferng with?

      (Absent Minded, Excessive Hunger, Lumbago, Acne, Excessive Worry, Mental Disorder, Alcoholism, Faint When Hungry, Motion Sickness, Allergies, Fatigue, Nausea, Anemia, Feels Shaky if Hungry, Nervous Disorder, Appendicitis, Foul Smelling BM, Night Blindness, Arthritis, Foul Smelling Urine, Pain w/bowel movement, Asthma, Frequent Colds, Poliomyelitis, Bad Breath, Frequent Kidney Infections, Prostate Trouble, Cancer , Frequent Lower Bowel Gas, Respiratory Problems, Chest Pains, Frequent Urination, Rheumatic Fever, Chills/Cold Skin, Gallstones, Sexual Disorders, Cold Hands/Feet , Hay fever, Sinusitis, Constipation, Headaches, Skin Problems, Crave sweets/coffee, Heart Disease, Sluggish in the A.M., Depression, Heart Pounds Hard, Swollen Glands, Diabetes, Hemorrhoids , Too Fast Digestion, Diarrhea, High Blood Pressure, Tuberculosis, Difficulty Breathing, Hot Most of the Time, Ulcers/Colitis, Digestive Disorders, Indigestion/Heartburn, Venereal Infection, Dizziness, Insomnia, Wake Up Tired, Eat When Depressed, Irritable before Meals, Weight Problem, Eat When Nervous, Itching of the Nose, Eating relieves fatigue, Itching of the Rectum, Eczema, Kidney Stones, Emphysema, Light-headedness, Excessive Fear, Low Blood Pressure)
      List all medicine, pills, or drugs you are taking now
    1. GODLY TRUST

    2. Occupations
    3. What hours do you work?
    4. Health of spouse (if applicable):
    5. How many children do you have?
      Ages
    6. Health of children
    7. Recreational activities enjoyed
    8. Hours per week viewing TV
    9. Do you often feel guilty about past mistakes?
    10. Do you worry about the future?
      Do you have stress?
    11. Do you suffer with depression?
    12. Check the following categories which cause stress
    13. On a scale of 1 to 10 rate your stress level (1= very little stress and 10=an extreme amt. of stress)?
    14. Do you enjoy the work that you do?
    15. If Not, Explain
    16. Are you developing your mental and spiritual capabilities
      by daily study, meditation and prayer?
    17. Are you involved in some type of activity in which you are helping others
    18. The following space is provided for those who would like to elaborate more on the causes of their stress, depression and other negative emotions.
    19. OPEN AIR

    20. How many hours daily do you spend out of doors?
    21. Do you sleep with your windows closed?
    22. Are you able to breathe fresh air while you are working?
    23. Is the building where you work a none-smoking facility?
    24. DAILY EXERCISE

    25. How often do you exercise?
    26. Describe the exercise:
    27. How do you feel after you exercise?
    28. SUNSHINE

    29. How much time daily do you spend out of doors in the sunlight?
    30. Do you oftern get sunburned?
    31. Do you visit tanning beds?
    32. Are you afraid of getting skin cancer?
    33. PROPER REST

    34. What time do you go to bed?
    35. What time do you awaken?
    36. What time is your last meal before retiring?
    37. Do you snack just before bedtime?
    38. Do you wake up during the night and snack?
    39. If so, what do you eat?
    40. Do you have trouble sleeping?
    41. Explain
    42. LOTS OF WATER

    43. How much water do you drink daily?
    44. What type? (spring, filtered, distilled, tap)
    45. Check below the beverages you drink and indicate how much of each
      BEVERAGE NAME BRAND #OF Glasses, Cans or Bottles Daily
    46. What is the usual color of your urine?
    47. Explain your understanding of the principles of hygiene
    1. ALWAYS TEMPERATE

    2. Do you ingest caffeine in any form?
    3. If so, for how many years?
    4. Have you ingested caffeine in the past?
    5. For how many years?
    6. If so, when did you stop?
    7. Do you smoke or chew tobacco?
    8. Indicate which
    9. If so, for how many years?
    10. Have you used tobacco in the past?
    11. For how many years?
    12. If so, when did you stop?
    13. Do you drink alcohol?
    14. If so, what kind?
    15. For how many years?
    16. Have you drank alcohol in the past?
    17. For how many years?
    18. NUTRITION

    19. Do you overeat?
    20. Do you feel stuffed after your meals?
    21. Do you eat between meals?
    22. Do you drink with your meals?
    23. If so, what liquids?
    24. Do you wear removable dentures or plates?
    25. Do you eat fast?
    26. How long does it take you to eat?
    27. Do you have a peaceful environment at meal times?
    28. Do you have set meal times?
    29. Are you following any special diet?
    30. Explain what type
    31. Do you eat animal products?
    32. If so, what kind?
    33. How Often?
    34. Do you eat dairy products?
    35. Do you eat desserts, candy or other sweets regularly?
    36. Explain how often and what Type
    37. What time do you eat breakfast?
    38. What foods do you usually eat?
    39. How often do you eat a tossed green leafy salad?
    40. How often do you eat steamed or cooked vegetables?
    41. How often do you eat fruits?
    42. How often do you eat soup or stew?
    43. What time do you eat lunch (dinner)?
    44. What foods do you eat?
    45. What time do you eat supper?
    46. What foods do you eat?

    BILLING INFORMATION

    PAYMENT OPTIONS

    Submit $75 donation to complete the consulation process.

    Make your payment directly into our bank account. Please use your Order ID as the payment reference. Your order will not be shipped until the funds have cleared in our account.

    Card Accepted
    Card Number
    Name On Card

    Your credit card will be charged $75.00

© Copyright 2016 by M.E.E.T Ministry. All rights reserved.
DESIGN BY

The information provided in this website is designed for educational purposes online and reflects the Biblical life-style designed by God for our health and happiness. The information presented herein is not to be used as medical advice or to diagnose or treat disease. Rather, it reflects the convictions, of Bible-believing Christians in regard to our Biblical understanding of how to cooperate with God in the work of healing-which He promised to do. Therefore, the use or misuse of any information contained herein is at the sole risk and discretion of the user and neither the authors nor designers of this web site are liable for any negative effects, or worthy of praise for any positive results. For diagnosis, treatment or any other procedures including allopathic medical advice, see your doctor. For healing, see the Great Physician. (Psalm 103:1-3, Exodus 15:26).