Supplement Consults

Dr. Cindi is now offering the benefit of her 32 years of professional expertise for personal supplements consults. Her mastery and continued learning in the supplement field provides her patients with an opportunity for prioritizing, strategizing, assessing, and optimizing their own personal supplement plans with the benefit of Dr. Cindi's vast knowledge resources.

Not sure of what supplements to take? Need access to professional grade supplements? Are you interested in the convenience of ordering from home and having your items shipped directly to you?

We can help! Dr. Cindi is now proudly participating in the FullScript patient portal and offering all of these solutions.

How it works

Schedule and prepay your personal supplement consult with Dr. Cindi.
Choose whether phone ($35) or in person consult ($40). On the day of your scheduled consult:

assemble your supplements
complete your questionnaire
talk with Dr. Cindi at your scheduled time

Consults last 20-30 minutes. Afterward, Dr. Cindi will email you your personal recommendations and FullScript portal access, along with your portal discount.

Order all your supplements through FullScript and they conveniently ship to you!

Our FullScript Patient Portal provides you access to thousands of products from reputable wellness companies all at a private savings. FullScript also offers pet products and more!

Schedule your supplement consult today! (770) 479-9784

Please complete all three forms listed below.

Advanced Cardiometabolic Analysis

Name

First Name

Last Name

Phone Number

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Stress

Do you feel worried, anxious, or on edge?

Do you feel overly stressed?

Do you experience mental fogginess or have trouble concentrating?

Do you have trouble falling asleep or staying asleep?

In the last six months, have you unintentionally lost or gained ten or more pounds?

Do you wake feeling unrested or depend on caffeine to keep yourself going throughout the day?

Diet

Do you typically snack on chips, cookies, crackers or granola?

Do you regularly consume soft drinks or fruit juice?

Do you have frequent sugar cravings?

Do you eat within three hours of bedtime?

Do you regularly eat at restaurants or consume prepared foods form the grocery store?

Environmental Factors

Are you sensitive to smells or fragrances?

Do you regularly have less than one or more than three bowel movements per day?

Do you take a laxative more than twice a month?

Do you regularly have headaches or migraines?

Do you have regular exposure to exhaust fumes, tobacco smoke, pesticides, commercial chemicals, paint, cleaning chemicals, or volatile fumes?

Exercise and Physical Activity

Generally do you enjoy exercising?

Do you exercise regularly?

In the last month, how many exercise sessions did you complete?

Please rate the intensity of your exercise sessions:

1 being the least intensity and 5 being the highest intensity.

What is the average length of time of your exercise sessions?

Pillars of GI Health

Pillars of GI Health Form

Name

First Name

Last Name

Phone

(###)

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Please list your top 3 major health concerns in order of importance:

Diet and Gastrointestinal Health

Do you consume at least five servings of fruits and vegetables per day?

Do you drink at least eight 8 oz glasses of water every day?

Have you ever been diagnosed with a chronic GI condition?

Digestion and Absorption

Do you experience freuqent heartburn, burping, gas, or bloating during or immediately after meals?

Have you ever been diagnosed with anemia or any other nutrient deficiency?

Have you ever been placed on a heartburn medication (proton pump inhibitor (PPI) of H2 blocker)?

Do you frequently experience indigestion?

Do you consume alcohol, antacids, or antinflammatory/pain killer drugs regularly?

Microbial Balance

Have you used antibiotics within the past two years?

Do you experience abdominal bloating, pain, gas, constipation or diarrhea?

Have you ever been diagnosed with chronic fatigue syndrome, fibromyalgia or irritable bowel syndrome?

Do you experience poor memory, difficulty concentrating or brain fog?

Barrier Function

Have you ever been diagnosed with depression, anxiety, ADD, or ADHD?

Do you suffer from multiple food sensitivities?

Do you experience skin issues such as acne, rosacea, or eczema?

Do you have seasonal allergies, asthma, or an autoimmune disease?

Overall Immune and Inflammatory Balance

Do you tend to catch colds easily or recover slowly from illness?

Have you been diagnosed with a recent or chronic infection, such as lyme disease, Epstein-Barr, Candidiasis, herpes simplex?)

Do you suffer from chronic fatigue or chronic pain?

Do you have unexplained rashes, redness, or itching?

Stress Recovery

ARK Stress Recovery Program

Name

First Name

Last Name

Email Address

Phone

(###)

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Blood Sugar Imbalance

Do you experience symptoms of hypoglycemia such as dizziness, shakiness or brain fog between or following meals?

Do you frequently miss or delay meals?

Do you frequently crave sugar or refined carbs?

Do you consume excessive sugar or refined carbs?

Are you diabetic or pre-diabetic?

Do you regularly consume alcohol or caffeine?

If yes, how much do you consume per day?

Mental and Emotional Stress

Do you frequently experience anxiety?

Do you suffer from depression?

Do you suffer from mood swings?

Do you have difficulty getting motivated?

Do you frequently experience feelings of agitation, anger, fear, or worry?

Sleep Cycle Disturbances

Are you not sleeping enough hours?

Are you not able to fall into a deep sleep?

Do you suffer from light cycle disruption or shift work issues?

Inflammation

Musculoskeletal: do you suffer from headaches, muscle, back or joint pain?

Gastrointestinal: do you suffer from IBS, Crohn's disease, or diverticulitis?

Respiratory: do you suffer from asthma, bronchitis, seasonal allergies or hay fever?

Auto-Immune: do you suffer from any auto-immune condition such as MS, lupus, or rheumatoid arthritis?

Immunological: do you suffer from food allergies, chronic infections, or frequent illness?