Client Assessment
Diagnosed Illnesses/changes since last assessment
New Signs & Symptoms (Mental/Emotional/Physical)?
When did this start?
What was going on around that time?
NEW INTERVENTIONS/TREATMENTS TRIED
Changes to Medications/Supplements
SCORE: Energy Levels*
SCORE: Sleep Quality*
SCORE: Physical Symptom Severity*
SCORE: Mental/Emotional Symptom Severity*
SCORE: Day to Day Symptom Impact*
SCORE: Life Fulfillment/Satisfaction*
ASSESS: Waist Measurement
ASSESS: Height to Waist Ratio
ASSESS: Blood Pressure*
ASSESS: Proprioception (Standing & Lying)*
ASSESS: HRV amplitude*
ASSESS: ANS Agility (renewing/depleting thoughts)*
ASSESS: Energy Systems (DER/TW/Meridians)*
ASSESS: Hormones (Triple Axis)*
OTHER NOTES



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