Take Our Short Quiz! A few simple question can help you reach your goals! Welcome . Our short quiz can help you determine how toxic your habits are and what we can do to help. 1.) Do you smoke or are you exposed to second hand smoke?. Yes No2.) Do you exercise / work up a sweat everyday? Yes No3.) Do you have issues with your skin? This includes eczema, acne, psoriasis and other skin conditions. Yes No4.) Do you drink tap or well water without filtering out fluoride, chloramines, perchlorate and pesticide residues? If you are not 100% sure because you haven't checked which chemicals your filter removes, then answer "yes". If you DON'T have a filter, the answer is "yes". Yes No5.) Do you use Teflon (non-stick) cookware? Yes No6) Do you eat conventionally raised meat? Yes No7.) Do you have mercury amalgams ("silver" fillings) in your teeth? And/or have you had braces with metal brackets? Yes No8.) Do you eat packaged / processed foods, canned foods on a regular basis? Yes No9.) Do you eat large fish (salmon, cod, swordfish, tuna) more than once a week? Yes No10.) Do you store food in plastic containers? Yes No11.) Do you rely on caffeine, energy drinks or stimulants to get you through the day? Yes No12.) Do you experience bloating, gassiness or indigestion frequently? Yes No13.) Do you regularly eat sugar (candy, pastries, soda, desserts) or breads (toast, muffins, crackers, pasta, etc.)? Yes No14) Do you drink alcohol everyday? Yes No15.) Do you use regular household cleaning products? Yes No16.) Do you have at least one bowel movement everyday? Yes No17.) Do you often feel tired, have low energy, brain fog or poor memory? Yes No18.) Have you used antibiotics, prescription meds, or OTC meds (including birth control) in the past 6 months? Yes No19.) Have you done a detoxification or body cleanse program with in the last year? Yes No20.) Are there any pesticides or weed-killers inside your home and on your yard? Yes No21.) Do you eat conventionally raised (non organic) fruits and vegetables? Yes No22.) Do you use regular personal care products? If you are not consciously buying 100% herbal-based shampoo, conditioner, deodorant, soap, moisturizers, makeup, toothpaste, etc. then the answer is "yes") Yes NoThank you for taking our Toxicity Quiz by Envision Wellness at DocJacey.com. To see your results please fill out the contact information below. Sincerely Dr. Jacey Folkers Envision Wellness 4611 S 96th St #139 Omaha, NE 68127 (402) 281-0825 NameEmailPhoneWould like us to contact you about your results?