Intestinal Parasites

Answer the questions below, using the symptom scale:

0=Never 1=Seldom 2=Occasionally 3=Frequently

4=Infrequently with severe symptoms 5=Almost always

Contact with animals

Anal itch, fissures, rashes

Family members infected

Eating meats rare

Constipation

Food Allergies

Hives

Chronic Fungal infections

Eating Sugery / Starchy Junk food

Your Name

Contact with grass, clay

Skin problems

Chronic Fatigue

Eating processed meats, ham, etc.

Bloating, Flatulence

Diarrhoea

Had Parasites before?

Abdominal cramps, pain

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