SUBMIT YOUR

QUESTIONAIRE

This will allow us to track your progress when we check-in with you on week 4.

BODY TEMPERATURE & SLEEP

DIET & LIFESTYLE

STOOL

STRESS & ANXIETY

MENSTRUAL CYCLE (SKIP IF NOT APPLICABLE)

MEDICAL HISTORY

YOUR "BEFORE" PICTURES

1. Please upload PHOTOS showing any problem areas on your body, face.

2. Please upload a tongue photo, taken first thing in the morning before brushing your teeth, eating or drinking anything.

CLICK HERE TO UPLOAD YOUR BEFORE PHOTOS

WAIVER & AGREEMENT

I confirm that I have read and agree to terms & conditions listed in The Gut Lab Reset Waiver.

I confirm that I have read and agree to the Terms of Use