Adrenal-Fuel™ Stress Recovery Formula: Symptom Survey

by NatraTech May 19, 2020

Adrenal-Fuel™

Stress Recovery Formula

Symptom Survey

Thank you for choosing Adrenal-Fuel™ Stress-Recovery Formula! We are confident that you will experience positive results from the use of this state-of-the-art formula.

It will be beneficial for you to monitor your success, so you will be aware of the positive changes you can experience when you give your body the nutrients that support healthy adrenal & thyroid functions.

Please use the Survey below to document your improvements. We would love to hear about your success!

Symptom Survey

Adrenal Exhaustion

Please place a corresponding number for the symptoms listed below at the beginning of the program and again at the end of the first, second and fourth week.

0 = No occurrence, or does not apply

1 = Mild occurrence

2 = Moderate occurrence

3 = Severe occurrence

Symptoms	Start	1-week	2-weeks	4-weeks
Fatigue and lack of energy	_____	_____	_____	_____
Inability to lose weight	_____	_____	_____	_____
Food cravings and blood sugar problem	_____	_____	_____	_____
Food or airborne allergies	_____	_____	_____	_____
Poor recovery from illness	_____	_____	_____	_____
Headaches	_____	_____	_____	_____
Difficulty with PMS or menopause	_____	_____	_____	_____
Inability to concentrate or focus	_____	_____	_____	_____
Difficulty sleeping or insomnia	_____	_____	_____	_____
Depression, mood swings, irritability	_____	_____	_____	_____
Mid-afternoon slumps	_____	_____	_____	_____
Difficulty building muscle and tone	_____	_____	_____	_____
Recovery from exercise	_____	_____	_____	_____

Adrenal-Fuel Product Information