Dr Hagmeyer Health Questionnaire 15 minute

Name*
First Last
Please take a moment to complete this short questionnaire. Once submitted, You will receive an email shortly with our initial recommendations. Be sure to check your email and spam.
Email*
We would love to talk with you! First tell us what are your Top 3 or 4 Health Concerns?*
How Soon are you looking to work with our office.*
Have you been diagnosed with an Autoimmune Disease ?*
- Yes
- No
- Not Sure- Need Help in determining this
Do you feel you have had the proper testing to treat your condition properly?*
- Yes
- No
- Not Sure- Need Help in determining this
Do you feel you need more help with diet? Or are you looking to dig deeper into the root cause of your health problems with Functional lab testing.*
When was the last time you had blood work?*
- Within the last 3 months
- Within the last 6 months
- It has been over 12 months
How would you rate the complexity of your case- Mild, Moderate, Severe ?*
- Mild
- Moderate
- Severe
What have you done up to this point in an effort to regain your health ?*
Final Question- Unfortunately, Insurance covers only the most basic testing. Functional lab testing is not covered. We will try to do everything we can stay within your financial budget. How would you describe your Health Budget?*
- Less than $500
- $500-$1,000
- $1,000-$2,000
- $2,000-$4,000
- $6,000-$7,000
Your Financial budget determines what labs we use, the kinds of testing we would recommend, and how thorough of a workup than can be performed.
Optional Message
After Dr. Hagmeyer reviews your questionnaire you will be contacted via email with your next steps.

Suspect a Thyroid problem?

Complete our short health questionnaire right now to see if you are likely to be struggling with Thyroid disease

Lets Get Started

Do you suspect Candida Overgrowth?

Take the Quiz Right now and find out If you are likely suffering from Candida and how you score. Once completed you will receive several recommendations based on your score

Take Candida Quiz Now

Struggling with IBS, Bloating, Frequent gas, Skin problems?

Find out if this sneaky gut infection and overgrowth of bacteria is really to blame for your IBS, bloating, fatigue, skin issues, or other unexplained symptoms!
Take the Quiz Right now and find out how you score compared to people who don’t have SIBO.
Once completed you will receive several recommendations based on your score.

Take SIBO Quiz Now

Struggling with Fatigue/Adrenal issues?

Take the Quiz Right now and find out how you score compared to people who don’t have Adrenal Fatigue. Once completed you will receive several recommendations based on your score
Lets Get Started