Sophus
The Toxic Exposure Questionnaire
Have you been exposed to environmental toxins?
Could your health conditions and symptoms be due to chronic environmental toxic exposure?
Take this questionnaire and find out!
1 / 5
Select all the boxes that apply to the patient (check all that apply):
2 / 5
Select all the boxes for lab findings that the patient currently experiences (check all that apply).
3 / 5
Select all the boxes for occupations or hobbies that the patient has undertaken, either currently or in the past (check all that apply):
4 / 5
5 / 5
Select all the boxes for the medical conditions that the patient has been diagnosed with (check all that apply):
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