Acupuncture Clinic Toronto
Click to learn about the conditions we treat at our clinic

No Payment,
No Paperwork,
No Hassle

Direct insurance billing available for
MASSAGE THERAPY

SHIATSU

REFLEXOLOGY

ACUPUNCTURE




If you have employee benefits, we may be able to bill your insurance company directly for your treatments.
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416-929-6958


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Toxicity Test

(More Tests at bottom of page)

Toxicity Screening Questionnaire

Rate each of the following symptoms based on your typical health profile.

Point Scale:
0 = Never or almost never have the symptom
1 = Occasionally have it; effect is not severe
2 = Occasionally have it, effect is severe
3 = Frequently have it; effect is not severe
4 = Frequently have it; effect is severe
 

HEAD

Headaches
Faintness
Dizziness
Insomnia

SKIN

Acne
Hives, rashes, dry skin
Hair loss
Flushing, hot flashes
Excessive sweating

WEIGHT

Binge eating/drinking
Craving certain foods
Excessive weight
Compulsive eating
Water retention
Underweight

EYES

Watery or itchy eyes
Swollen, reddened or sticky eyelids
Bags or dark circles under eyes
Blurred or tunnel vision*
*Not including near or farsightedness

HEART

Irregular or skipped heartbeat
Rapid or pounding heartbeat
Chest pain

ENERGY/ACTIVITY

Fatigue, sluggishness
Apathy, lethargy
Hyperactivity
Restlessness

EARS

Itchy ears
Earaches, ear infections
Drainage from ear
Ringing in ears, hearing loss

LUNGS

Chest congestion
Asthma, bronchitis
Shortness of breath
Difficulty breathing

MIND

Poor memory
Confusion, poor comprehension
Difficulty concentrating
Indecisiveness
Stuttering or stammering
Slurred speech
Learning disabilities
NOSE
Stuffy nose
Sinus problems
Hay fever
Sneezing fits
Excessive mucus formation

DIGESTIVE TRACT

Nausea, vomiting
Diarrhea
Constipation
Bloated feeling
Belching, passing gas
Heartburn
Intestinal/stomach pain

EMOTIONS

Mood swings, anxiety, fear, nervousness
Anger, irritability, aggressiveness
Depression

MOUTH/THROAT

Chronic coughing
Gagging, frequent need to clear throat
Sore throat, hoarseness, loss of voice
Swollen/discolored tongue, gums, lips
Canker sores

JOINTS/MUSCLES

Pain or aches in joint(s)
Arthritis
Stiffness/limitation of movement
Pain or aches in muscles
Feeling of weakness or tiredness

OTHER

Frequent illness
Frequent or urgent urination
General itch or discharge
   Totals
Head
Skin
Weight
Eyes
Heart
Energy
Ears
Lungs
Mind
Nose
Digestive tract
Emotions
Mouth/Throat
Joints/Muscles
Other
Grand Total

Result:

 

 

Related Link: Health & Nutrition Consultation

Try another test:


 

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The Pacific Wellness Institute
80 Bloor St. West, Suite 1100, Toronto, ON M5S-2V1, Canada
416-929-6958

Copyright 2001-2009 The Pacific Wellness Institute. All Rights Reserved.
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Acupuncture and alternative medicine in Toronto from Pacific Wellness.
Acupuncture, shiatsu, RMT massage, naturopathy, reflexology and other alternative modalities for wellness, weight loss, fertility, pain control.