What SHAPE Is Your Health In?

What SHAPE is Your Health In?

Our SHAPE ReClaimed quiz is a great way to see what SHAPE your health is in. Your results can help you decide whether to embark on a SHAPE ReClaimed journey. Share the results with your practitioner and come back and take the SHAPE ReClaimed quiz to see how your health improves along the way.

Select answers based on your symptoms over the last year.

Click "Next" to get started!

Start the SHAPE ReClaimed Quiz

Symptoms: Select the number that best describes how you have experienced each symptom over the last year:

0 = never    1 = occasionally    2 = frequent/mild    3 = frequent/moderate    4 = frequent/severe    5 = always

Acid reflux, heartburn
Acne
Anxiety
Asthma
Belching, passing gas
Bleed or bruise easily
Bloating
Blurred or tunnel vision
Body odor
Breast masses or fibroids
Brittle nails
Bronchitis
Brown age/liver spots
Chemical sensitivities
Chest congestion
Chest pain or pressure
Chronic coughing
Cold/canker sores
Constant sneezing
Constipation
Cravings
Cysts, boils
Depression
Diarrhea
Difficulty breathing
Difficulty concentrating
Difficulty falling/staying asleep
Difficulty losing weight
Dizziness, faintness
Ear drainage
Earaches, ear infections

0 = never    1 = occasionally    2 = frequent/mild    3 = frequent/moderate    4 = frequent/severe    5 = always

Eczema, psoriasis
Erectile dysfunction
Excessive sweating
Excessive thirst/hunger
Fatigue, low energy
Food sensitivities/allergies
Frequent colds or flus
Frequent need to clear throat
Gallbladder problems
Gout
Hair loss or thinning
Hay fever, seasonal allergies
Headaches, migraines
Hemorrhoids
High blood pressure
Hives
Hot/cold intolerance
Hyperactivity
Incontinence
Indigestion
Insomnia
Intestinal or stomach pain
Irregular, skipped heartbeat
Irregular periods
Irritable when hungry
Itchy ears
Itchy skin, dermatitis
Joint pain
Kidney stones
Low back pain
Low blood pressure

0 = never    1 = occasionally    2 = frequent/mild    3 = frequent/moderate    4 = frequent/severe    5 = always

Low blood sugar
Low libido
Mood swings
Muscle cramps, spasms
Muscle pain, aches, weakness
Nausea, vomiting
Nose bleeds
Painful or heavy periods
Poor memory
Premenstrual syndrome (PMS)
Prostate problems
Rapid or pounding heartbeat
Skin rashes
Shortness of breath
Sinus congestion or infection
Sore throat, hoarsenes
Stiffness, limited movement
Stuffy nose
Swelling, edema
Swollen lymph nodes
Swollen tongue, gums or lips
Tendonitis, bursitis
Tinnitus, hearing loss
Ulcers
Urinary tract problems
Vaccine reactions
Vaginal discharge
Varicose veins
Watery or itchy eyes
Weight gain
Yeast infections

Conditions: Have you ever been diagnosed with any of the following? Select Yes or No

ADD/ADHD
Anxiety
Arthritis
Asthma
Autoimmune condition
Celiac disease
Colitis, Crohn's disease
Depression
Diabetes
Eczema, psoriasis
Fibromyalgia
GERD
Gout
Gouty arthritis
Hay fever, seasonal allergies
Heart disease
Hepatitis, liver disease
Hypoglycemia
Infertility
Insulin resistance
Irritable Bowel Syndrome
Restless leg syndrome
Seizure disorder, epilepsy
Thyroid condition

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