Find out why you might have health problems by taking our FREE Symptom Survey.

Dr. Glen Burford extends an invitation to you to receive a Symptom Survey and evaluation free of any charge or obligation.

Any unwanted health or body condition you have has an underlying cause. Left untreated the “symptoms” can worsen over time and lead to further ill health and more unwanted conditions.

This is a test of common symptoms which can give an indication of possible causes of health conditions. Developed over many years of research, the survey classifies over 220 symptoms by likely physiological cause. For those people with health issues who are interested in what is actually causing their problems, this can be a very valuable tool.

A test and evaluation of this kind would normally cost you $300.00 and up. It is offered to you here free of charge.

If you are unhappy with your health or physical condition, you can find out why.

This survey is not intended to diagnose any disease or illness and is for use only by a professional health practitioner in conjunction with a physical examination.

All information from this test is considered private medical information and is protected under law from unauthorized disclosure. We are prohibited by law from releasing your name, address or phone to any other organization or person.

Your test will be reviewed and one of our associates will call you to discuss:

• More information and explanation on the likely causes of your health problems based on this survey.
• Actions you could take yourself to help improve your health.
• Recommendations for workshops and/ or services from the center that could help you regain your health.

INSTRUCTIONS

Check the box that applies to you. Check either:

1. MILD (problem occurs rarely)
2. MODERATE (problem occurs several times per month)
3. SEVERE (problem is constant or almost constant)

If you do not experience a symptom, leave it blank by not selecting any boxes.