(281) 725-6767 [email protected]

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Quiz: Can We Work Well Together? Robert Busalla 2021-03-10T21:59:05+00:00

QUIZ

Quiz: Can We Work Well Together?

Lifestyle

I am willing to modify my lifestyle in order to improve my health. *

I Strongly AgreeI Somewhat AgreeI Neither Agree nor DisagreeI Somewhat DisagreeI Strongly Disagree

I am willing to abstain from foods and food-like-substances which may be destroying my health, wellness, and longevity. *

I Strongly AgreeI Somewhat AgreeI Neither Agree nor DisagreeI Somewhat DisagreeI Strongly Disagree

I am willing to eat healthy foods which can improve my health, wellness, and longevity. *

I Strongly AgreeI Somewhat AgreeI Neither Agree nor DisagreeI Somewhat DisagreeI Strongly Disagree

I am willing to trust that my desires for destructive foods and behaviors will decrease. *

I Strongly AgreeI Somewhat AgreeI Neither Agree nor DisagreeI Somewhat DisagreeI Strongly Disagree

I am willing to trust that my desires for healthy foods and behaviors will increase. *

I Strongly AgreeI Somewhat AgreeI Neither Agree nor DisagreeI Somewhat DisagreeI Strongly Disagree

I am willing to swim against the strong social currents of doubt, disbelief, and mockery as I forge a new path for myself towards long-term health, wellness, and longevity. *

I Strongly AgreeI Somewhat AgreeI Neither Agree nor DisagreeI Somewhat DisagreeI Strongly Disagree

I am willing to find and join a community of people committed to the functional medicine health journey. *

I Strongly AgreeI Somewhat AgreeI Neither Agree nor DisagreeI Somewhat DisagreeI Strongly Disagree

Methodology

I prefer to find and implement a natural, holistic remedy when possible instead of an artificial pharmaceutical treatment of symptoms. *

I Strongly AgreeI Somewhat AgreeI Neither Agree nor DisagreeI Somewhat DisagreeI Strongly Disagree

I am willing to have my genetics tested and revealed to my functional and collaborative provider team and staff in order to create a precise, customized plan for my health journey. *

I Strongly AgreeI Somewhat AgreeI Neither Agree nor DisagreeI Somewhat DisagreeI Strongly Disagree

Collaboration with Team

I am willing to learn and comply with the natural, functional approach to health care and wellness to prioritize finding a long-term natural solution over merely treating symptoms. *

I Strongly AgreeI Somewhat AgreeI Neither Agree nor DisagreeI Somewhat DisagreeI Strongly Disagree

I am willing to fully collaborate in the thorough investigation of the root causes of my health issues, including completing exhaustive questionnaires to enable my functional and collaborative provider team to be prepared in advance of my appointments. *

I Strongly AgreeI Somewhat AgreeI Neither Agree nor DisagreeI Somewhat DisagreeI Strongly Disagree

I am willing to be completely honest and forthright with my functional and collaborative provider team and staff. *

I Strongly AgreeI Somewhat AgreeI Neither Agree nor DisagreeI Somewhat DisagreeI Strongly Disagree

I am willing to arrive at my appointments at or before the scheduled time. *

I Strongly AgreeI Somewhat AgreeI Neither Agree nor DisagreeI Somewhat DisagreeI Strongly Disagree

I am willing to always speak and behave respectfully toward my functional and collaborative provider team and staff. *

I Strongly AgreeI Somewhat AgreeI Neither Agree nor DisagreeI Somewhat DisagreeI Strongly Disagree

Out of respect for those with MCS (Multiple Chemical Sensitivities), I am willing to abstain from wearing fragrance of any kind to my appointments in the office, including but not limited to body wash, lotion, hair spray, perfume, cologne, etc. *

I Strongly AgreeI Somewhat AgreeI Neither Agree nor DisagreeI Somewhat DisagreeI Strongly Disagree

Financial

I am willing and able to invest financially in my health, wellness and longevity with cash, credit card, HSA card, or flex spending card since the practice does not process or take insurance. *

I Strongly AgreeI Somewhat AgreeI Neither Agree nor DisagreeI Somewhat DisagreeI Strongly Disagree

First Name *
Last Name *

Email *

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Hope for Healing
121 Vision Park Blvd #200,
Shenandoah, TX 77384-3027

Call Now: 281.725.6767
Fax: 888.886.9009
Email: [email protected]

Mon-Thurs: 8:30AM-4:30PM (Closed 12-1PM)

Friday: 8:30AM-3PM (Closed 12-1PM)

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