The Wellness Quiz

Wouldn't you like to feel better, look better and have more energy?

Welcome to the Wellness Quiz. Here is your opportunity to discover how you are doing with your health, and how to make it better. You can receive a "Wellness Report" specifically for you, based on your responses to the questions.

The Wellness Quiz has been developed over a period of nearly 40 years by Jonathon Miller, nationally-known wellness educator and author. He began using a questionnaire in consultations with people back in 1978.

At that time, Jon's first book, Nutrition, Health & Harmony: A Handbook Of Natural Health was published. It became one of the early classics of the natural health movement.

Over the years he has studied and/or worked with a number of doctors and other leaders in the field of wellness as he continually developed the Wellness Quiz.

If you would like to look over the Wellness Quiz to see what it is like, scroll down the page. There are a lot of items, but you can actually go through them quickly. It's just a matter of checking the ones for which you say "Yes".

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"After being on a program of many vitamins & minerals, the greatest relief from my pain in the colon, urethra and bladder areas came after I undertook Jonathon Miller's herbal program."

-- Rebecca Eisenhut, Exec. Director of Listen-To-Me-Now (a program for the hearing impaired)

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"My memory has improved and my sinus problems have vanished."

-- Linda Snowden, Physician's Assistant

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We want YOU to be well, to feel good, and to have plenty of energy left after doing your necessary tasks, so you can do what you want to do also.

Beyond that, our goal is to bring greater well-being to the whole community. This is a holistic wellness adventure for which the Wellness Quiz is just the starting point.

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Take the Wellness Quiz for only $10 for each person.

If you have not already paid, click on the payment link below to pay for your Wellness Quiz & Report. After making your payment, click on the button to be returned to this site where you can complete the Quiz below.

You can pay for as many people as you want to take the Quiz. After submitting a Quiz, you can use the "RESET" button to clear the check boxes and information so another person can do theirs and submit it.

Your Wellness Report(s) will be sent by e-mail within a few days ONLY if you have paid for the analysis.

NOTE: Our payment processor, PayPal, is the largest online payment service, a subsidiary of eBay. It is totally secure.)

 

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to pay for one or more Wellness Quizzes.

SPECIAL!

If you order a Wellness Quiz you will also receive my eBook:

ReallyWell: Secrets of Wellness Made Simple

(for more info on the eBook go to: ReallyWell eBook )

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CHECK the box in front of an item to indicate "YES".
SKIP the item if your response is "NO".

IMMUNE SYSTEM
1. Do you have more than one sore throat or cold a year?
2. Do you have sore throats, colds or bouts with flu lasting longer than 4 days?

RESPIRATORY SYSTEM
3. Do you have recurring infections?
4. Are you often short of breath without much exertion?
5. Do you breathe heavily after climbing a long set of stairs?
6. Do you tend to get a side ache when running or from other physical exertion?
7. Do you have respiratory allergies (eg., pollen, fumes)?
8. Do you have or suspect you have food allergies?

CIRCULATORY SYSTEM
9. Is your heartbeat irregular?
10. Does your heart rate become rapid with only slight exertion?
11. Does your heart beat flutter at times?
12. Have you had a heart attack?
13. Have you had a stroke?

EXTREMITIES
14. Are your hands and/or feet often cold?
15. Do your ankles, feet or hands swell (water retention)?
16. Do you sometimes have tingling, burning or numbness in your hands, arms, legs or feet?

NERVES & BRAIN
17. Do you have frequent nervous twitches?
18. Do you feel seriously stressed by your circumstances?
19. Are you a nervous person?
20. Do you often feel tense?
21. Do you at times feel depressed?
22. Are you anxious about possible events?
23. Do you get irritated easily?
24. Are you forgetful or confused?
25. Do you have a hard time concentrating?

COMMON PROBLEMS
26. Are you frequently tired?
27. Do you have a hard time getting up in the morning?
28. Do you get light-headed when hungry?
29. Do you get headaches frequently?
30. Do you ever feel dizzy or off balance?
31. Does eating improve the way you feel?
32. Do you find yourself bingeing at times?
33. Do you seek stimulation from coffee, alcohol, candy, etc.?
34. Does it seem that you are thirsty overly much?
35. Do you have high energy soon after consuming sweets?
36. Are you tired or sleepy a while after consuming sweets or starches?

WEIGHT PROBLEMS
37. Are you overweight?
38. Are you excessively overweight?
39. Do you have difficulty reducing weight, if needed?
40. Do you need assistance to reduce weight?
41. Are you underweight?
42. Do you have or think you might have an eating disorder?
43. Is it hard to gain weight even though you are eating well?

DIGESTIVE SYSTEM
44. Do you have frequent indigestion?
45. Do you have stomach gas, feel bloated, or belch after meals or snacks?
46. Do you get stomach aches?
47. Do you have an intestinal gas problem (flatulence)?
48. Are you sometimes constipated (bowels hard to move well)?
49. a) Do your bowels move less than 2 times a day?
b) Do your bowels move less than once a day?
50. a) Do your bowels move more than 3 times per day?
b) Do you have frequent diarrhea (loose watery stools)?
51. Do you commonly have an excessive urgency to move your bowels?
52. Does your rectum itch occasionally?
53. Does food take more than 15 hours to pass through?
54. Do your stools have a overly foul odor?
55. Do your stools have a light color and float?
56. Is your stool sticky (leaving anal residue) frequently?
57. Do fiber foods bother you?

MINERALS
58. Do you get leg cramps?
59. Do you have calcium deposits?
60. Do you have soft or brittle bones?

DENTAL PROBLEMS

61. Have you had a lot of dental caries & cavities?

62. Do you have silver fillings in your teeth?
63. Do you have sore or sensitive gums?

64. Do you ever have jaw popping or pain in the jaw?
65. Is your bite irregular?
66. Do you chew more on one side of the mouth?

URINARY SYSTEM

67. Do you feel the need to urinate more frequently than normal?
68. Do you have trouble initiating urination?
69. Do you have trouble expelling urine thoroughly?

OTHER PROBLEMS
70. Are you weak muscled?
71. Do you have trouble falling asleep or sleeping deeply?
72. Do you have a halitosis ("bad breath") problem?
73. Do you have periods of hyperactivity?

FEMALE CONDITIONS
74. (Female) a) Do you have PMS problems?
b) Are you menopausal or post menopausal?
75. (Female) Have you had vaginal yeast problems?
76. (Female) Have you had swelling or lumps in a breast?
77. (Female)a) Have you given birth to children?
b) Are you currently pregnant or nursing?

SEXUAL PERFORMANCE (male or female)
78. Do you have a diminished sex drive?
79. Is the duration of your sexual arousal insufficient?

EYES
80. Are there any ruptured blood vessels in the whites of your eyes?
81. Are your eyes abnormally sensitive to light or wind?

SKIN PROBLEMS
82. Do you bruise easily?
83. Do cuts & bruises heal slowly?
84. If you cut yourself, is the bleeding slow to stop?
85. Do you have excessively dry skin and/or hair, and/or brittle nails, and/or dry mouth?

LIFESTYLE PROBLEMS
86. Do you smoke?
87. Do you smoke 1/2 pack per day or more?
88. Do you smoke a pack per day or more?
89. Do you drink more than one cup of coffee per day?
90. Do you drink alcoholic beverages more than 2 times per week?
91. Do you drink more than 2 alcoholic drinks in a day or evening?

WATER
92. a) Do you drink and cook with unfiltered tap water?
b) Do you bathe and/or shower in unfiltered tap water?
93. Do you drink less than 40 oz. of pure water per day?

FOOD CHOICES
94. Do you drink more than 2 cans of soda pop per week?
95. Do you eat sugar, candy, ice cream, baked goodies, etc.?
96. Do you often consume items with Nutrasweet(tm) / Aspartame(tm) in them?
97. Do you consume less than one cup of raw vegetables and one cup of raw fruits daily?
98. Do you consume more than 4 cups of dairy milk per week?
99. Do you eat more than 4 servings of cheese, yogurt, sour cream and/or ice cream per week?
100. Do you try to eat a concentrated protein food (meat, fish, milk, cheese, eggs, nuts, seeds) at every meal?
101. Do you consume "red" meat (beef, pork, lamb, venison, etc.) more than 3 times per week?
102. Do you eat processed meats (weiners, sausage, pepperoni, baloney, etc.)?
103. Do you eat more than 3 servings a week of white flour products (white bread, rolls, pasta, etc.)?
104. Do you eat less than 3 servings per week of whole grain foods (whole wheat bread, brown rice, oatmeal, barley, etc.)?
105. Do you eat products made from soybeans more than once a week?
106. Do you regularly consume more than one of these foods in the same meal: meat, fish, cheese, egg, cereal, bread, pasta, rice, fruit/fruit juice, sweets?
107. Do you drink beverages with meals?
108. Do you use salt or salted foods?
109. Do you consume "junk" foods and "junk" snacks regularly?
110. Do you skip breakfast?
111. Do you snack between meals and/or in the evening?
112. Do you commonly eat late in the evening?
113. Are you a vegetarian?
114. Do you cook some of your food in a microwave oven?

OTHER HEALTH CONCERNS
115. Are you in an electronic field very much of the time (eg., on a computer, near utility wires, etc.)?
116. Do you walk briskly or exercise aerobically for at least 20 minutes LESS than 3 times a week?
117. Do you have a serious medical condition for which you are currently under a physician's treatment?
118. Are you currently taking any medications?

NUTRITIONAL SUPPLEMENTS
119. Do you take 2000 IU or more of vitamin D₃ daily?
120. Do you take 500 mg. or more of Vitamin C daily?
121. Do you take Vitamin E regularly?
122. Do you take other antioxidants regularly?
123. Do you take B-vitamins or a multi-vitamin regularly?
124. Do you take extra calcium regularly?
125. Do you take extra magnesium regularly?
126. Do you take a "trace mineral" product regularly?
127. Do you consume "superfoods" (eg. spirulina, cereal grass juice or powder, etc.) daily?
128. Do you take herbal products regularly?
129. Do you take supplemental enzymes regularly?
130. Do you consume foods or supplements rich in Omega 3 fatty acids regularly?

KNOWN HEALTH CONDITIONS
Indicate any of the following conditions that have been identified as a concern for you by clicking on the box:

131. "Age Spots"
132. Aging
133. AIDS or HIV
134. Allergies
135. Alzheimer's
136. Anemia
137. Angina
138. Anxiety
139. Arthritis - Osteo
140. Arthritis - Rheumatoid
141. Asthma
142. Back Pain
143. Cancer (Type):
144. Candida Yeast

Cardiovascular Problems
145. Arteriosclerosis
146. Blood Pressure High or Hypertension
147. Blood Pressure Low
148. a) Cholesterol High b) Triglycerides High
149. Heart Attack
150. Heart Weakness
151. Mitral Valve
152. Pulse Rate Rapid
153. Stroke

154. Carpal Tunnel Syndrome
155. Cataracts
156. Chronic Fatigue Syndrome
157. Cravings For Junk Foods
158. Cystic Fibrosis
159. Depression
160. Diabetes

Digestive Tract Problems
161. Colitis
162. Constipation
163. Crohn's Disease
164. Diarrhea (Recurring)
165. Diverticulosis / Diverticulitis
166. "Heartburn" / Acid Reflux
167. Hemorrhoids
168. Irritable Bowel Syndrome
169. Ulcers

Ear Problems
170. Fluid
171. Infections
172. Hearing Loss
173. Tinnitus (Ringing)

174. Epilepsy
175. Fatigue
176. Fibromyalgia
177. Gall Stones
178. Hair Loss
179. Headaches
180. Headaches -- Migraines
181. Hernia -- Hiatal
182. Hernia -- Abdominal
183. Herpes
184. Hormonal Problems
185. Hot Flashes
186. Hypoglycemia (Low Blood Sugar)
187. Immune System Weakness
188. Insomnia
189. Irritability
190. Liver Problems
191. Lupus
192. Lyme Disease
193. Menstrual Cramps (Female)
194. Multiple Sclerosis
195. Muscle Cramps
196. Muscle Soreness
197. Osteoporosis
198. Pancreas Problems
199. Parkinson's
200. Prostate Gland Problems (Male)
201. Sciatica
202. Sexual Dysfunction
203. Sinus Problems

Skin Problems
204. Acne
205. Cancer
206. Excema
207. Rash
208. Wrinkles

209. Sports Injuries
210. Sports Nutrition
211. Stress
212. Throat -- Excess Mucus
213. Throat -- Recurring Infection
214. Thyroid Problems

Urinary Tract Problems
215. Bladder Weakness
216. Inflammation / Infection
217. Kidney Stones
218. Kidney Weakness

219. Varicose Veins

Vision Problems
220. Macular Degeneration
221. Night Blindness
222. Weak Eyesight

OTHER PERSONAL INFORMATION
Please Record (if known)

223. Are you a a) male or a b) female?

224. Height:
a) 4 ft. 5 in. or below
b) 4 ft. 6 in. - 4ft. 9 in
c) 4 ft.10 in. - 5 ft. 1 in.
d) 5 ft. 2 in. - 5 ft. 5 in.
e) 5 ft. 6 in. - 5 ft. 9 in.
f) 5 ft.10 in. - 6 ft. 1 in.
g) 6 ft. 2 in. - 6 ft. 5 in.
h) 6 ft. 6 in. - 6 ft. 9 in.
i) 6 ft.10 in. - 7 ft.1 in.
j) 7 ft. 2 in. or over

225. Weight:
a) under 80 lbs.
b) 80-100 lbs.
c) 101-120 lbs.
d) 121-140 lbs.
e) 141-160 lbs.
f) 161-180 lbs.
g) 181-200 lbs.
h) 201-220 lbs.
i) 221-240 lbs.
j) 241-260 lbs.
k) 261-280 lbs
l) 281-300 lbs.
m) 301-350 lbs.
n) over 350 lbs.

226. Age:
a) 1-9 years
b) 10-17 years
c) 18-34 years
d) 35-49 years
e) 50-59 years
f) 60-69 years
g) 70-79 years
h) 80-89 years
i) 90-99 years
j) over 100 years

227. Eye Color:
a) Brown
b) Hazel
c) Green
d) Blue

228. Original Hair Color:
a) blonde
b) red
c) auburn
d) brown
e) black

229. Complexion:
a) light (fair)
b) moderate
c) ruddy (reddish)
d) dark

230. Ethnic background:
(NOTE: You may indicate more than one, but limit to major influences. This information is
not required. You may choose not to give it.)

a) African
b) Asian
c) Central or Northern European
d) Mediterranean
e) Middle Eastern
f) Hispanic
g) Native American
h) Pacific Islander
i) Other


Please provide us with at least your name and the valid e-mail address where you receive e-mail and read it, which should be the same e-mail address you use for PayPal.

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If you have completed the Wellness Quiz to your satisfaction and entered the needed personal information, please read the following "Disclaimer", then click on the "SUBMIT" button below.

NOTE: We do not process quiz submissions without the $10 payment. Please click here to submit payment if not yet done.


DISCLAIMER
The educational information offered in The Wellness Report is based solely on the indications provided by the client in their responses to the questions in The Wellness Quiz. The report is not a medical diagnosis. The information provided is drawn from the author's more than 27 years of experience in the natural health field, including writing five books; and the current level of research and knowledge available to him. This information is not a substitute for consulting a qualified health care practitioner.

The client is advised to make use of the Wellness Report judiciously on their own responsibility. There is no warranty regarding the results of using this information, and the author and publisher disclaim any liability for the actions of the client.


JUST A FEW DAYS
Your Wellness Quiz and personal information will be forwarded to us. We will process it and respond with your Wellness Report within one to three business days (excluding weekends and holidays).


If you are ready to submit your responses and other information, CLICK ON the "SUBMIT" button. (NOTE: For greater confidentiality of your responses, only the Quiz numbers are being transmitted, not the word descriptions.)



If you would like to clear the Quiz form, either to start over or for a new person to take the Quiz, the "RESET" button has been provided for that purpose.

THANK YOU!
We appreciate your support of the Wellness Quiz.

We recommend reading our wellness e-book, ReallyWell: Secrets Of Well-Being Made Simple. Click here to learn more about our e-book and order it.