Stress affects you more profoundly

- and in more ways -

than you think!

Stress impacts your health, from the smallest cell on up. It's a whole body experience - and not usually in a good way.

This short but powerful survey gives you insight into what aspects of your whole body health are most affected by stress.

Dr. Winters will review your answers personally, and we'll send you her top three recommendations based on your results.

First Name *

Last Name *

Email *

Please rate how well the following statements match your life situation.

Some of these may be tough to answer!

Do your best, and remember – this is just between us.

I wake up refreshed and ready for the day: *

Rarely/never

Occasionally (1-2 days/week)

Frequently (4-5 days/week)

Almost always (6-7 days/week)

My daily activity level is: *

I am mostly sedentary.

I am easily fatigued and/or in pain; exercise is difficult for me.

I am sporadic with exercise / on a “boom or bust” cycle.

I don’t exercise regularly, but I am in motion most of the day.

I try to get in 10 – 25 minutes of some kind of exercise 3-5 times a week.

I am an exercise ninja.

My weight is: *

Great!

It would be nice to lose 5 pounds, but it’s not a priority.

I’ve put on 10 -20 pounds in the last few years.

I’m more than 20 pounds over my ideal weight.

I’m underweight.

My outlook on life is: *

It’s not perfect, but I’m happy most days.

Life is pretty challenging; I’m feeling a bit overwhelmed.

I feel tired &/or irritable a lot of the time.

I don’t want to get out of bed; it’s all too much.

My diet is: *

Vegetarian / vegan

Keto

Mostly pre-packaged meals &/or restaurant meals

Mostly home-cooked / fresh food & some convenience foods

Heavy on meat and starches like potatoes.

Heavy on snacks; I really crave salty/sweet foods.

My digestion is: *

Great! I poop every day without fail.

Mostly good: I have occasional bloating / gas.

I have acid reflux/GERD.

I am constipated &/or have frequent diarrhea.

A problem: I’ve been diagnosed with a digestive condition.

My environment is (all that apply): *

I live/work near heavy traffic, industrial plants or farms, electrical or cell phone towers

I have chronic sinus or respiratory issues

I am sensitive to chemicals, perfumes, cleaning products, etc

I have chronic headaches, joint or muscle pain, or skin isses

You're done!