Healthexcel's "Advanced Program" Metabolic Type Testing Questionnaire

THe

one2one utrition

Metabolic typing test

" Advanced Program "
Metabolic Type Assessment

Terms & Conditions: One2One nutrition Ltd

• One2One nutrition are a limited company registered at:

The Barn house, Dairy business park, brewerstreet, Bletchingley, Surrey

• One2One nutrition has offices based at (Please use this for postal correspondence)

6 Briscoe Rd, Colliers Wood, London, SW19 2AQ,

• UK Limited Company registration number: 5475353

• One2One nutrition are an approved and official provider of Metabolic Typing via the Healthexcel Metabolic Typing system. (www.healthexcel.com).

• One2One nutrition will keep all personal details private and confidential and will not disclose any information to 3rd parties.

Pre-course requirements.

• All participants must inform myself of any previous health complaints and/or conditions that they may be affected by.
• All participants must consult a doctor before embarking on the program.
• All participants must sign the terms & conditions before the programme may begin.

Payments

• The Metabolic typing course is to be paid through 10 installments of £14.99
• Payment must be made:
Through Paypal’s internet subscirption payment page

Refunds & guarantee

• The participant is entitled to a full refund of any payments if they give notification in writing before they submit the Biochemical analysis questionnaire.
• The participant is entitled to a cancel the course at any time if they feel unhappy with quality of the course. To do this they must email one2one nutrition at info@one2onenutrition.co.uk with valid reasons for discontinuing the course.

The course is guaranteed to achieve weight loss if you :
• Are currently classified as overweight, this means your body fat is 25% or above.
• Weight loss is defined as losing any percentage of body fat below initial value.
• Weight loss is not measured by weight, but by body fat, see article weight vs fat ?
• You complete the whole course and all the tasks set for you. Including 3 diet reocrd sheets per week.
• You eat at least 90% of your meals as recommended for your metabolic type.
• You implemnt all four areas of exercise at least 3 times per week.
• You take all the supplements as determined from your metabolic type.
• To recieve your money back guarantee you will first go through an intense coaching stage, this free four week period is deisgned investigate further the reasons why the ten week course did not work. If after this period and subject to the above fact you have not lost fat you will be given a full refund.
• All refunds must be submmitted within 15 weeks of the metabolic typing test submission date.

Appointments, timescale and course requirements

• The course must be completed within the maximum timescale of 12 weeks.
• The participant is obliged to complete the appropriate forms and sheets as directed by their advisor.

Points to Note:

• The nutritional program will give the foods and supplements necessary for your body at this moment in time. It may be that you will be required to eat meat, liberal amounts of fat and/or be required to stop consuming certain foods.
• The One2one nutrition program is in no way intended to cure or treat any specific conditions nor symptoms.
• Only your doctor can decide upon your requirements regarding drugs and medication to be/or not to be consumed. He/she should be kept informed throughout your program.

THe metabolic typing test is analysed by Heathexcel, you are completing tehir advanced version of the test.

After analysis, Your Results Will Be Returned to me -- normally within 48 business hours of receipt by the processing center.

STEP 1
Vital Statistics Table

Privacy Statement: The information that you provide in this form is for internal use only. Your name, address, and other information you provide will not be sold to advertisers or marketers.

Now you're ready to begin filling out the form . . .

To navigate through the form, you can use your mouse or you can also use your TAB key to move forward and Shift-TAB to move backwards.

Note that the following fields MUST be completed in order for your form to go through when you click Submit at the end:

LAST NAME, FIRST NAME, SEX, AGE, HEIGHT (feet and inches), WEIGHT, IDEAL WEIGHT, TEST NUMBER, ADVISOR, ADVISOR CERT #, PRIMARY HEALTH COMPLAINTS, SIGNATURE (in Step 2).

   NOTE: In order for your data to submit properly,
    you MUST complete all fields in this section

   Last Name: 
  First Name: 
         Sex: (M)ale (F)emale
         Age:      
      Height: feet' 
      Height: inches"
      Weight: pounds
Ideal Weight: pounds
 Test Number: This is my 
                   (1,2,3,etc.) test.

Primary Health Complaints: 


       Advisor: 
 Advisor Email: 
Advisor Cert #:


             Date: eg, June 1,2000
      Street/Road: 
        City/Town: 
State/County/Prov: 
         Zip/Post: 
          Country: 
        Day Phone: ^*
      Night Phone: ^*
              Fax: ^*
        Birthdate: eg, May 18,1949
   Marital Status: (S)ingle,(M)arried,(D)ivorced
        Hair Test:Yes No
        ( Are you doing a Hair Analysis with this evaluation? )
If Female, are you in Menopause? 
                  Yes No
   
* NOTE: Please provide complete numbers,
   including country code, area code, etc.


                Occupation: 
Occupation Before Retiring:

STOP!
Make sure that the following fields contain data in the table above. Otherwise, when you submit your form, it will NOT go through!
LAST NAME, FIRST NAME, SEX, AGE, HEIGHT (feet and inches fields), WEIGHT, IDEAL WEIGHT, TEST NUMBER

STEP 2

Informed Consent

Before you begin to answer your questionnaire, it is necessary that you read the following disclaimer and sign your name electronically to signify your agreement with its content. one2one nutritions terms and conditions and allow us to go ahead and process your evaluation. Thank you.

Healthexcel's Metabolic Typing concepts and any accompanying individualized ecological lifestyle recommendations that may be made are based on our own theories drawn from the ideas of past researchers in the field and on our empirical and objective observations made from working with thousands of individuals over the past 20 years. These theories have not been scientifically proven. Thus, the accuracy of our theories or the validity of our recommendations, nutritional or otherwise, have not been scientifically confirmed. Certain persons considered experts may disagree with one or more of our concepts or recommendations. We are not nutritionists or licensed dietitians, but rather consider ourselves to be Metabolic Typing™ Advisors. Our purposes are educational and informational only and we assume no responsibility for the correct or incorrect use of our information. Any information we provide and any recommendations we make should not be used to, nor are they intended to, nor do they in fact diagnose, treat, cure or mitigate any specific health problem. Anyone with any health complaint should seek the care and consultation of an appropriate licensed health practitioner. No attempt should be made to use any information we provide as a form of treatment for any specific condition without the approval and guidance of a physician.

" I, the undersigned, do hereby state that I have read the above statement and understand that the purpose of the Healthexcel Programs (under guidence from one2one nutrition) is solely to provide information concerning my individual ecological lifestyle. I further understand that any recommendations made are in no way intended to, nor do they in fact diagnose, cure, treat, mitigate or prevent any specific illness or disease."

To sign your name electronically, enter a " / " at the start and the end of your name.
Example: /John Doe/

" By electronically signing my name in the box below, I am indicating my
acceptance of the content of the Informed Consent statement above."

Signature

Please check and make sure you used a " / " at the start and the end of your name.
Without it, your form will be considered unsigned and will not be accepted.
Thank you.

Now you're ready to start the questionnaire!

STEP 3

" Advanced "
Metabolic Type Testing
Questionnaire

Tips For Viewing and Navigating The Questionnaire

You can navigate either:
- by using your Tab key to move from one question to another and your up/down Arrow keys to select your answer, or
- by using your Mouse and Scroll Bar and clicking in the circle next to your answer.
If the type size appears too small or too large, you can change the setting in your browser.

In Internet Explorer, on the top menu, click /View /Text Size and select Larger or Smaller.
In Netscape, on the top menu, click /View /Text Size and select Larger or Smaller.

Remove any Toolbars you don't need in order to see more screen.
- Click on /View /Toolbars and uncheck any you don't need. Or, click on /View /Full Screen.

Questionnaire Instructions:

In the questionnaire below, make only one selection per category (except where otherwise indicated).
If no choice applies to you, leave that category unchecked .
Answer all questions the way you are NOW, not the way you used to be, or think you should be, or how you were before getting sick.
Important: The choices as written may not describe you exactly. So, it is very important that you choose the answer that best describes your tendencies . The answer does not need to be a perfect description, just an indication of your trend or tendency.
It is strongly recommended that you let a close friend or family member check your answers for accuracy, especially the questions in the Psychological Traits section.
Be as honest and accurate as you can. After all, you want to be sure to obtain the right information about your Metabolic Type.
If you can't decide on an answer, leave the question blank. Do NOT choose the "middle" or average response just because you are uncertain of your answer.
When finished, click the "Submit For Evaluation" button at the bottom to email your answers to the Healthexcel Processing Center.
Be sure to make a backup copy of your form by following the instructions exactly at the end of the form.

Physical Traits
B O D Y S T R U C T U R E
Build ( at ideal weight ) Tend toward a lean, wiry, thin, rangy or gangly build Average build Tend toward a stockier, wider or thicker-type build Cellulite I tend to accumulate cellulite on . . . Upper arms Upper hips Lower hips / buttocks Front thighs Outer thighs (saddlebags) Knees Upper back Cellulite, Main Area Main area cellulite accumulates . . . Knees and/or chest / breasts Stomach and/or back Buttocks and/or outer thighs (in "saddlebags") Upper thighs All over ( not accumulated in specific areas) Fat Distribution, From Back From a back view, most of my excess weight (fat) is ... ...Around the waist (in "love handles") ...Especially across the upper back (but also may have thickening all over body) ...Below the waist and/or in the rear ...Fat accumulates all over (not in specific areas) Fat Distribution, From Front and Side Views From the front and side views, most of my excess weight (fat) is ... Across (protruding) stomach in a pouch, "beer-belly" or "pot-belly", and also across chest Across the stomach in a roll(s), (in a "spare-tire") On outer thighs and in rear Evenly distributed all over, including around knees, not more above or below waist Fat Distribution, Hands and Feet Tend to put fat on hands/feet Never get fat on hands/feet Rib Cage Tend toward smaller, narrower, or thinner-type rib cage / chest Average-sized rib cage / chest Tend toward large, round, or deep rib cage, "barrel-chested" Weight Currently am overweight Currently am at a good weight for me Currently am underweight	Female Only Body Shape At Ideal Weight By "Ideal Weight" is meant the weight at which you look and feel your best Not fat but full-figured; strong, sturdy; carry more mass above than below waist Lean, slender, fine-boned, graceful, good balance of mass above and below waist Slim with curvy hips and rear; upper body notably smaller than lower body; lower body appears stronger than upper body Appear childlike, underdeveloped, or more girlish appearance, appear in the body more like a young girl than a woman Body Shape With Extra Weight Select the answer which BEST describes how your body accumulates weight (gains fat), when it changes from your ideal weight to excess weight Stocky, square, heavy limbed, a general thickening all over, full-figured, no pronounced curve at waist or hips, weight on upper back, prominent stomach, carry more weight on front than on back, may show extra weight on hands, feet, face; rear gains less weight than stomach area Body well-shaped/proportioned but noticeably heavier, fuller in the middle (waist, hips, thighs), than in the extremities. Neck, arms, calves, ankles gain much less mass than middle and may appear thin. Fairly even proportion between upper and lower body with well-defined waist. Upper body (above waist) appears noticeably smaller (even 1-1.5 sizes smaller) than lower body (below waist); carry most extra weight in rear and outer thighs ("saddlebags"); less weight in stomach than in rear end Childlike shape, underdeveloped look with fat (often like "baby fat") accumulating all over, not in special areas. Pudgy. Undefined outline with little curve at waist. Notable weight accumulation in knees, hands and feet. Breasts ( without implants ) Have large breasts Have average size breasts Have small breasts Buttocks With Extra Weight Tend to have a large rear; in profile, it protrudes prominently Average rear in proportion to body Tend toward a small, flat or "tucked-under" rear Male Only Body Shape At Ideal Weight By "Ideal Weight" is meant the weight at which you look and feel your best Not fat but strongly built, like a football player; large chest, thick, strong arms and legs Appear boyish, slender, like at age 14-15 Lean, slender, fine-boned, rangy, like a basketball player, long arms and legs Body Shape With Extra Weight Select the answer which BEST describes how your body accumulates weight (gains fat), when it changes from your ideal weight to excess weight Stocky, square, heavy-limbed, a general thickening all over; protruding stomach ("potbelly"), more weight on upper body, but face, hands, feet all show weight gain; arms and legs also show gain Upper and lower body appear well-proportioned, but noticeably heavier, fuller in the middle (waist, hips, thighs), than in the extremities in a "spare tire". Neck, arms, calves, ankles remain leaner looking than your middle Childlike or boyish shape, underdeveloped look with fat (often like "baby fat") accumulating all over, not in special areas; pudgy with undefined shape
E Y E S
Appearance / Look Wide-awake look and/or eyes protrude Average look to the eyes Dreamy look and/or eyes appear deep-set Blinking Go long time without blinking or often stare Average blinking activity Often blink Itching Eyes ( not from allergy or candida ) Often get Occasionally get Rarely get Moisture Eyes tend to be dry Eyes not particularly dry or moist, don't notice Eyes notably moist or tearing	Puffiness Around Eyes Tend to have Occasionally have Rarely or never have Pupil Size ( in normal-lighted room ) Pupil = black, center portion of eye. Iris = colored portion, encircling pupil (refer to your Special Tests Instructions for help) Takes up more than � the width of the iris Takes up � the width of the iris Takes up less than � total width of iris
H E A D
Eyebrows Thick, heavy or bushy Average eyebrow growth Thin, light or scanty Facial Features Tend toward angelic, delicate or finely-chiseled features Average features, not notably coarse or delicate Tend toward more coarse, large or heavy features Have child-like facial appearance	Head Shape ( bone structure at ideal weight ) Head tends toward the elongated, with a slender, thin or narrow face Average-shaped head, face Have more of a squarish or rounded head and face Head Size Head appears slightly large in proportion to body Average-sized skull in proportion to body Head appears slightly small in proportion to body
M O U T H
Gum Bleeding ( from brushing teeth ) Often occurs Sometimes occurs Rarely occurs, if ever Gum Color Bright red or pink color Medium pink color Light or pale pink color Saliva Amount Excessive amount and/or drooling Normal amount Notable dry mouth tendency	Saliva Quality Thick, sticky, stringy, or ropey Neither thick nor thin Thin, runny, or watery Swallowing Often hard to swallow, throat seems to tighten up Sometimes hard to swallow Rarely or never hard to swallow Teeth Sensitivity ( to hot, cold or acids ) Teeth often sensitive Teeth occasionally sensitive Teeth rarely or never sensitive
S K I N
Cold Sores / Fever Blisters Often occur Sometimes occur Rarely occur, if ever Dandruff Tend to have Sometimes have Rarely or never have Ear Coloring ( compared to face and neck ) Flushed, pink, red Average Light, pale Facial Coloring Flushed, pink, ruddy Average (for skin tone) Pale Facial Complexion Bright, clear Average More of a dull, pasty look Fingernails Tend to be thin, weak, bend easily Average thickness Tend to be thick, strong Gooseflesh or Goosebumps Easily or often form Occasionally form Rarely form, if ever	Insect Bite Reaction Strong reaction, goes away slowly Average reaction Mild reaction, goes away quickly Itching Skin ( anywhere ) Often have Occasionally have Rarely have Moisture of Skin Tends to be dry Not particularly dry or moist Tends to be moist Rashes, Hives Tend to get Occasionally get Rarely get, if ever Scalp Moisture Tends to be oily Neither dry nor oily Tends to be dry Toughness Skin tends to be thick, tough Average skin quality Skin tends to be thin, weak, delicate
D I G E S T I O N
Belching / Burping After Meals Rarely or never need to burp Occasionally have burping Often have burping Digestion, Efficiency Find meat hard to digest Find fats/oils hard to digest Have average digestion Have to be careful of what I eat Have really good digestion, easily digest most foods Digestion, Speed Rapid: stomach empties (clears food) quickly Average Slow: stomach empties slowly	Intestinal Gas 2 Hours After Eating Often get Sometimes get Rarely or never get Stomach Pains ( heartburn, sour stomach, indigestion, nausea ) Tend to get stomach pains that are RELIEVED BY eating Don't normally get stomach pains Often get stomach pains FROM eating Thirst Feelings Often feel thirsty Occasionally feel thirsty, have average thirst Rarely feel thirsty
E L I M I N A T I O N
Bowel Movements - Color Typically dark brown or green Usually seem to be average brown color Often light in color Bowel Movements - Frequency of Natural Movement Usually have 1-2 B.M.'s each day Usually have 2 or more B.M.'s each day Usually have 1 B.M. every other day Usually have 1 B.M. every 2-3 days or longer Often need enemas or laxatives in order to evacuate bowel Bowel Movements - Firmness Tend to have hard or dry stools Usually average firmness and moisture content Tend to have soft, mushy or watery stools Bowel Movements - Size Usually large in diameter Usually average in diameter Usually small or narrow in diameter Diarrhea ( when not ill ) Tend to get diarrhea Occasionally have diarrhea Rarely, if ever, have diarrhea	Mucous in Stool Often have mucous in stool Sometimes have mucous in stool Rarely, if ever, have mucous in stool Incontinence ( bowel or bladder ) Often have this problem Occasionally have this problem Don't have this problem Urine - Control Can hold easily and for a long period Can't hold well, hard to Have trouble stopping flow without dribbling Don't have trouble stopping flow without dribbling Urine - Frequency ( daytime ) More than 5x per day Usually 4x per day 3x or less per day
R E F L E X E S
Gag Reflex Tend to gag easily Average gag reflex Weak gag reflex NeuroMuscular Reflexes Tend to have fast reflexes Average reflexes Tend to have slow reflexes Pain Sensitivity Very sensitive to pain, don't tolerate well Average pain sensitivity Somewhat insensitive to pain, can handle a lot	Strong Light Strong, bright light really bothers me. Need to wear sunglasses Average reaction Has no effect, doesn't bother at all Sudden Loud Noise Can really make me jump Little or no reaction Average reaction
R E S P I R A T I O N
Asthma Never have Occasionally have, or have a mild problem Often have Breathing Rhythm Tends to be irregular Sometimes irregular Almost always regular Chest Pressure ( inhibits breathing ) Often have Occasionally have Rarely or never have Coughing ( not from allergy or illness ) Often or daily Occasionally Hardly ever Often cough right after eating Gasping ( air hunger ) Often have a "sudden gasp for breath" or need to take a big breath or feel like I don't get enough oxygen Occasionally have a "sudden gasp for breath" or need to take a big breath or feel like I don't get enough oxygen Never or almost never have a "sudden gasp for breath" or need to take a big breath or feel like I don't get enough oxygen Hay Fever Have during hay fever season Only occasionally have during season Never have during hay fever season	Hoarseness Tend to get hoarse often Occasionally hoarse Rarely, if ever, hoarse Nasal Membranes ( when not ill or allergic ) Tend to be moist or runny Neither dry nor moist or runny Often feel too dry Respiration Rate More than 20 breaths per minute Between 13 and 20 breaths per minute Less than 13 breaths per minute Sighing or Yawning ( during day, not at night ) Usually sigh or yawn every day Occasionally sigh or yawn Rarely sigh or yawn Sneezing ( not from allergy or illness ) Sneeze almost every day Occasionally sneeze Rarely sneeze Wheezing ( not from allergy or illness ) Tend to have problems with wheezing Occasionally wheeze Rarely or never wheeze
M I S C E L L A N E O U S
Climate Love/do better in warm or hot weather Do equally well in warm or cool weather Love/do better in cool or cold weather Fever ( when ill ) Tends to be higher Average fever Tends to be lower	Physical Endurance Can work steadily for many hours at a time Average endurance Tend to do better working in spurts Stiffness Upon Arising Muscles often feel stiff upon arising Occasionally feel stiff upon arising Rarely feel stiff upon arising

Diet-Related Traits

It is very important that you answer this section as honestly and accurately as you can.
Your answers must reflect your true dietary habits, preferences and reactions.
If you don't know or are uncertain of your reactions to certain foods, experiment and test yourself before answering.
Do not be in a rush to complete the questionnaire. Take your time and consider your responses carefully.

Appetite At Breakfast
Strong
Average
Weak

Appetite At Lunch
Strong
Average
Weak

Appetite At Dinner
Strong
Average
Weak

Desserts
Love them
Can take them or leave them
Don't care for them

Eating Before Bed
Helps me sleep
Is okay unless I overeat
Usually don't sleep well if I do

Eating Habits
Need to eat often to be at my best
Average eating requirements
Unconcerned with food, may forget to eat

4 Hours Without Eating
Makes me irritable, jittery, weak, or depressed
Feel normal hunger without other ill effects
Doesn't bother me

Heavy Fat Meal
INcreases energy and well-being
DEcreases energy and well-being
No noticeable difference in energy

Hunger Feelings
Often feel hungry ( "live to eat" )
May feel hungry at mealtimes
Often don't feel hungry ( "eat to live" )

Juice or Water Fasting
Makes me feel awful
Do well fasting
React okay, can fast if necessary

Meal Portions
Prefer large portions
Like average portions
Prefer small portions

Orange Juice Alone ( with no other foods )
Energizes and satisfies me
Produces no ill effects
Can make me light-headed, hungry, jittery

Potatoes
Like them, could eat them daily
Don't care for them
Can take them or leave them

Red Meat ( steak, roast beef )
DEcreases energy and well-being
INcreases energy and well-being
No noticeable difference in energy

Salty Foods
Love salty foods
Average desire for salt
Food often tastes too salty

Skipping Meals
Must eat regularly ( and/or often )
Do best if I eat 3 meals a day
Can skip a meal with little or no ill effects

Snacking Need
Rarely want or need snacks
Often need to eat between meals
Occasionally need a snack

If I'm Low On Energy
Sweets restore/meat worsens energy
Sweets worsen/meat restores energy
Almost any food restores energy

Meat For Breakfast
Improves energy and well-being
Worsens energy and well-being
Makes no difference in energy

Meat For Lunch
Improves energy and well-being
Worsens energy and well-being
Makes no difference in energy

Meat For Dinner
Improves energy and well-being
Worsens energy and well-being
Makes no difference in energy

What foods do you currently crave ? Not necessarily right this minute....but what foods do you tend to crave on a daily basis in general ? (Check all selections that apply to you)
Red Meat Poultry Fish Other Seafood	Eggs Milk Cheese Yogurt
Grains Breads Cereals Grain Products	Fruits Sweets Candies Desserts
Salty Foods Fatty Foods Sour Foods Spicy Foods	.

Psychological Traits

Try to answer this section as honestly and accurately as you can.
If you don't know or are uncertain of the correct answer to a question, leave it blank. Do not guess or make a selection "by default."
It can be very helpful to ask a close friend or family member to review your answers in this section. Sometimes we do not see ourselves as others do. Hearing how others perceive us can be very helpful. But remember, no one knows you as well as you do, so what you feel and believe is the most important factor in making your selections.
Do not be in a rush. Take your time. Consider your responses carefully.

Being in Charge
Prefer to be, like it
Sometimes like to be
Prefer not to be, don't like it

Disagreement
Rather give in than argue a point
Sometimes feel like standing my ground
Rather argue than give in, can enjoy a debate

Exercise
Makes me feel good, love it
Sometimes like exercise
Dislike it, prefer to be sedentary

Loose Ends
Are upsetting to me
Sometimes bother me
Don't bother me

Punctual
Almost always punctual
Sometimes punctual
Find it hard to be punctual, try as I may

Achievement
Underachiever ( Type B Personality )
Average achiever
Overachiever ( Type A Personality )

Ambition
Not ambitious, quite unmotivated
Have average ambition
Quite ambitious, extremely motivated

Motivation/Drive
Have high drive & motivation
Average drive & motivation
Have low drive & motivation

Organization
Very organized
Average organizational ability
Tend to be disorganized

Pace of Living / Working
Fast-paced, fast worker ( " the hare " )
Average pace
Slow, steady pace ( " the tortoise " )

Perfection
Perfectionist, sometimes to a fault
Somewhere between the two
Getting it done is good enough for me

Procrastination
Rarely procrastinate
Sometimes procrastinate
Often procrastinate

Productive
Hard to focus and be productive - mind too spacey
Hard to focus and be productive - mind too hyper, scattered
Have average productivity
Very productive, get things done

Routines
Don't like routines
Sometimes follow routines
Prefer routines

Social Behavior
Sociable "people-person", love company
Loner, self-conscious, socially inhibited
Somewhere between the two

Task Completion ( mental and physical )
Complete tasks slowly, with effort
Complete tasks at an average pace
Complete tasks quickly, easily

Anger
Slow to anger, fairly even-tempered
Get angry if really pushed
Quick to anger, explode, but it passes quickly

Expression of Emotions
Hard to express emotions
Average emotional expression
Easy to express emotions

Temperament
Depressed, lethargic, apathetic
Calm, collected
Excitable, fiery, hyper, irritable

Tendencies
Laid-back, easy-going, go with the flow
Average, even emotions
Angry, nervous, high-strung, anxious

Activity Level
Very active, hard to slow down
Have average activity levels
More sedentary, easy to be inactive

Drowsiness
Rarely get drowsy
Sometimes get drowsy
Often get drowsy

Attentive to Details
Extremely
Pay average attention to details
Not very, just enough to get by

Concentration
Hard to concentrate, can't hold focus very long - too spacey
Hard to concentrate, can't hold focus very long - too hyper, scattered
Average ability to concentrate
No problem concentrating

Expression of Thought
Hard to put thoughts into words
Average ability to communicate thoughts
Easy to put thoughts into words

Orientation
Intellectual, rational, logical, left-brained
Emotional, feeling, intuitive, right-brained
Good balance between both

Accommodation
Tend to get my own way
Tend to give in, I'm an accommodator
I'm somewhere between the two

Attention Time Frame
Live in the future, not nostalgic
Live in the present, in the here & now
Live in the past, tend to be nostalgic

Cautiousness
Careful, conservative, reserved
Average caution
Adventuresome, daring

Challenges
Bored without them, thrive on them
Sometimes like challenges
Prefer stability, routine

Competitive
Love competition, it energizes me
Sometimes feel competitive
Dislike competition, avoid it

Feelings
I'm easily hurt by harsh words
Harsh words sometimes hurt me
Harsh words don't bother me much, if at all

"I Love"
Eating, food, and/or socializing
Nothing in particular . . . or most everything
Being by myself and/or exercising

Impatient
Tend to be impatient
Have average patience
Tend to be patient

Making Friends
Easily make friends
Sometimes make friends easily
Hard for me to make friends

Personality
Warm, accessible, sociable, outgoing
Neither outgoing nor withdrawn
Aloof, shy, keep more to myself

Reaction Time
Slow physical / mental / emotional reactions
Average reaction times
Fast physical / mental / emotional reactions

Stress
Try to avoid it, makes me depressed
Average reaction to stress
Stimulates me, react angrily or aggressively

CONCERNING YOUR TEETH
Use this chart to answer the questions that follow about your teeth.

LEFT SIDE TEETH

RIGHT SIDE TEETH

Upper
Teeth

# 16
Wisdom

# 15
2nd
Molar

# 14
1st
Molar

# 13
2nd
Bicuspid

# 12
1st
Bicuspid

# 11
Canine

# 10
Lateral
Incisor

# 9
Central
Incisor

# 8
Central
Incisor

# 7
Lateral
Incisor

# 6
Canine

# 5
1st
Bicuspid

# 4
2nd
Bicuspid

# 3
1st
Molar

# 2
2nd
Molar

# 1
Wisdom

Lower
Teeth

# 17
Wisdom

# 18
2nd
Molar

# 19
1st
Molar

# 20
2nd
Bicuspid

# 21
1st
Bicuspid

# 22
Canine

# 23
Lateral
Incisor

# 24
Central
Incisor

# 25
Central
Incisor

# 26
Lateral
Incisor

# 27
Canine

# 28
1st
Bicuspid

# 29
2nd
Bicuspid

# 30
1st
Molar

# 31
2nd
Molar

# 32
Wisdom

Mark any teeth below that have ROOT CANALS, using the chart above as a guide.
Upper Left #16 #15 #14 #13 #12 #11 #10 #9	Upper Right #8 #7 #6 #5 #4 #3 #2 #1
#17 #18 #19 #20 #21 #22 #23 #24 Lower Left	#25 #26 #27 #28 #29 #30 #31 #32 Lower Right
Mark any teeth below that have METAL DENTAL WORK (fillings, crowns, etc.), using the chart above as a guide.
Upper Left #16 #15 #14 #13 #12 #11 #10 #9	Upper Right #8 #7 #6 #5 #4 #3 #2 #1
#17 #18 #19 #20 #21 #22 #23 #24 Lower Left	#25 #26 #27 #28 #29 #30 #31 #32 Lower Right

WHAT IS YOUR BLOOD TYPE?

( Providing your Blood Type information is OPTIONAL )

Blood Type A1 Blood Type A2 Blood Type A1B Blood Type A2B
Blood Type B Blood Type O Don't Know

* NOTE: Be sure to make a backup copy of your form by following the instructions exactly at the end of the form in STEP 4 below.

Answer the following questions only if this test is NOT your first test.

Which Metabolic Type Diet have you been following ?

Diet Plan #1 Diet Plan #2 Diet Plan #3
No particular or special diet

How closely did you follow your Diet Program ?

Very Close Close So-so Not close Didn't follow

How did you feel on the Diet Plan ?

Felt well Felt poorly Felt OK

How did it impact your hunger?

Felt hungry or had cravings Wasn't hungry, no cravings

What was your overall reaction to the diet?

Was a good diet for me Was a poor diet for me, didn't do well

How closely did you follow your Supplement Program ?

Very Close Close So-so Not close Didn't follow

Did you take supplements other than those that were recommended in your Metabolic Type Program ?

Yes No

Please list any supplements you took that were not recommended on your Metabolic Type Program :

How are you now as compared to when you last retested ?

Better Same Worse

Please list any adverse symptoms or health complaints that you had at the time of your last test :

Please describe what the effects of your previous Metabolic Type Program have been on your health complaints :

Top Of Page Start Of Questionnaire

STEP 4
Submitting Your Form

After carefully checking all your input ( your Vital Statistics, signing the Informed Consent, your answers to the questionnaire ), choose one of the following options to have your evaluation analyzed:

If you're completing this form using an Internet browser ( like Netscape or Internet Explorer ) while you are "live" on line, just click the Submit For Evaluation button below
If you're completing this form on actual paper instead of on screen, you should know that your paper copy is an exact duplicate of the electronic format that you would see on screen. Thus, you can either:

Go online to https://www.healthexcel.com/public/advanced-s.html and easily transfer your data to the electronic form on your screen and then click the SUBMIT button, or
If you don't have a computer, go to a Kinko's or a library or a friend's house or anywhere you are able to use a computer to access the Internet and surf to
https://www.healthexcel.com/public/advanced-s.html, transfer your data to the electronic form on screen, and then click SUBMIT, or
If you absolutely can't access a computer, return your completed Metabolic Type Testing paper forms to your Healthexcel Metabolic Typing Advisor to make other arrangements for processing.

Make An Electronic Copy Of Your Form Before Submitting!!! Please note: Although it is unlikely that your computer will experience any problems responding to this form, certain non-standard browsers will not respond properly. If you experience any difficulties ( or if you are not using a forms-capable browser ), you may email your response to this form to: Advanced@healthexcel.com . It would also be a very good idea to save a copy of your form by sending an email copy to yourself. Do this BEFORE clicking on the Submit For Evaluation button below to send your form to the computer center. To perform either of these operations:

Highlight the entire document, from top to bottom
( While holding down the Control (Ctrl) key, hit the "A" key )

Copy your highlighted text to the Clipboard
( Click on /Edit /Copy, or hold down the Control (Ctrl) key and hit "C" )

Open up a new email message by clicking here: advanced@healthexcel.com
This will open up a new, blank email that is addressed to the computer center

If you are sending this email to the computer center, also send a copy to yourself by typing your email address in the Copy ( Cc ) box, or

If you just want to send a copy to yourself and not one to the computer center, type your email address in place of Advanced@healthexcel.com in the email address box

Set your email format for HTML ( not Plain Text )
[ For example, in Outlook or Outlook Express, on the top Menu, click on /Format /HTML. ]
In order to make an exact, duplicate copy, your email software must be able to send formatted ( HTML ) text

Click anywhere in the blank area where you would normally type your email message

Insert/Paste your document from the Clipboard (that you highlighted and copied in steps #1 & #2)
( Click on /Edit /Paste or hold down the Control (Ctrl) key and hit "V" )
Note that you must insert the copy of your form INSIDE the email message. Do NOT send it as an ATTACHMENT

Send the email message
[ When you receive the email containing a copy of your form, scroll through it and verify that all of your data is there. It should look EXACTLY like the form you filled out on the web site, with all of your answers and data appearing on the form in the same manner. If you do not see such a copy, then your email software is unable to send formatted HTML text and you will not be able to use this feature with your existing email client for saving a copy or sending data to the computer center. In this case, try using the free email client, Outlook Express. ]
When you receive the email message that you sent to yourself, you will have a copy of your form. Then, if any problem arises where you need to resubmit your form, you can just resend your email message to Advanced@healthexcel.com. That way, you will not need to go to the extra effort of filling out your form all over again. Contact your Advisor if you have any questions or need assistance.

Please Print Your Completed Form From Your Browser Before Submitting!!! Keep it on file for your permanent records. To print it, just click on /File /Print on your Browser's top menu bar. You can also just print a portion of it by highlighting a section, then clicking on /File /Print, and then clicking on Selection. Note that the size of the fonts on your printed page(s) will be determined by the View settings in your Browser. For example, in Internet Explorer, click on /View /Text Size to set the screen size and printing size of your fonts.

Reminder: After you have made your electronic copy and printed a copy for your files, be sure and click on the Submit button below to send your completed form to the the computer center for analysis.

Click the "Submit For Evaluation" button below
to send your data to the processing center.

Thank you !

For background information, visit Healthexcel's Website ( http://www.Healthexcel.com )
For education and training, visit MTEC -- Metabolic Typing Education Center ( http://www.MetabolicEd.com )
Look for The Metabolic Typing Diet published by Doubleday, January 2000 -- In bookstores everywhere and at Amazon.com ( Paperback, 420 pages, $10.47 )
Read more about the book at its website -- http://www.TheMetabolicTypingDiet.com