Language
English (US)
Spanish (Latin America)
Dr. Lori's Rapid - "Deconstructed" Supplement Recommendation Consult
Please take a few moments to complete this symptom review so that Dr. Lori Gerber can give you supplement recommendations personalized for you!
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Gender
*
Please Select
Male
Female
N/A
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Symptom Review - Please answer the following by ranking your symptoms from 1-5 - 1 being the least and 5 being the most, N/A if not applicable.
*
1
2
3
4
5
N/A
Fatigue
Hot Flashes
Night Sweats
Diarrhea
Constipation
Food Sensitivities
Anxiety
Depression
Mood Swings
Headaches
Insomnia
Sensitivity Heat/Cold
Brittle Hair/Nails
Difficulty AM Wake Up
Weight Gain
Belly Fat
Insulin Resistance
Diabetes
Weight Loss
Joint Pains
Body Aches
Loss Taste/Smell
Exercise Intolerance
Blurred Vision
New Vision Disturbances
History of Autoimmune
Disease
Brain Fog
Low Libido
Difficulty / Change
in Orgasm
Lack of Morning Erections
Erectile Dysfunction
History of Irritable Bowel
Syndrome
History of Inflammatory Bowel
Disease
Please provide any details or history of illness / symptoms?
*
Save
Submit
Should be Empty: