Heavy Metals Toxicity Questionnaire

Step 1 of 2

  • Heavy Metals Toxicity Questionnaire

  • Patient (your name, or if this is your child, the child’s name)

  • Instructions

    • Listed below are symptoms often found in patients who have absorbed excessive amounts of Heavy Metals: These poisonous metals include Lead, Mercury, Aluminum, Arsenic and Cadmium. All are found in modern environments
    • The best available diagnostic tool to determine Heavy Metal Toxicity is a combination Blood Metals Panel and a Mercury Tri Test. We offer these through our office.
    • Even if you have many of the symptoms below, you may not be Heavy Metal Toxic — there may be other causes. Certain combinations of symptoms are more accurate indicators.
    • If you checked a dozen or more symptoms - or have signicant exposures - you may have problems with Heavy Metals Toxicity.
  • Symptom List