Dr. Jeffery Fine | Board Certified in Gastroenterology

A Brief Test & Daily Food Journal

6750 N. MacArthur Blvd.,
Suite 250
Irving, TX 75039
Ph: 1-972-253-4205
Fx: 1-972-401-0458

Take this food sensitivity assessment below
and get results now!

(If you experience any of these symptoms below for a week or more,
please contact Dr. Fine’s office to schedule an appointment .)

Digestive Tract Diarrhea Constipation Bloated feeling Belching Passing gas Stomach pains Chest pain	Emotions Mood swings Anxiety, fear Irritability, anger Depression Aggressiveness Nervousness	Energy & Activity Fatigue Sluggishness Apathy Hyperactivity Restlessness Lethargy	Eyes Watery eyes Itchy eyes Dry eyes Swollen eyelids Dark circles Blurred vision
Weight Binge eating Cravings Excessive weight Compulsive eating Water retention Underweight	Joints & Muscles Pain in joints Arthritis Stiffness Limited movement Aches in muscles Feeling of weakness	Mouth & Throat Chronic coughing Gagging Often clearing throat Sore throat Swollen tongue/lips Canker sores	Nose Stuffy nose Sinus problems Hay fever Sneezing attacks Excessive mucous
Head Headaches Insomnia	Skin Hives, rashes Hair loss Flushing/hot flashes Excessive sweating	Lungs Chest congestion Asthma, bronchitis Shortness of breath Difficulty breathing	Mind Poor memory Confusion Poor concentration Stuttering/stammering Learning disability

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