Health Self-Assessment

Health Self- Assessment


Please complete the following sections that are relevant to your health. Select all the symptoms that you are currently experiencing. We will re-assess at a later time to see if your symptoms have improved, stayed the same or worsen. This will allow you to make valuable connections between your health and the food that you eat.


121 Dundas Street East

Suite 205

Advanced Wellness Centre

Belleville ON

Michelle Meilleur



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© 2016 by Michelle Meilleur