I have found the following Brain Function Questionnaire to be a quick and accurate assessment of a person's brain chemistry.  Also, I've found very few problems with mixing the recommended supplements with prescription antidepressants and other medications.  However, I do advise you to seek out the guidance of a health professional familiar with orthomolecular medicine to direct your treatment if possible.  (I can do that)

Some of these are tough, please know that these are kept in complete confidence and are only used to better focus our nutritional protocols.  I have seen everything so do not be alarmed if you only circle a few, or if it seems that you have circled EVERYTHING. The goal of this is to help you get more out of less and focus your efforts, instead of taking 30 different supplements and miracle cures that are simply"shotgunning" your health and may not be benefitting you at all. 

 Feel free to fax this to me at 901.767.8861, mail it to me, or drop it off here at the office.  You do not need to be a current patient of this clinic to use this form.

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