​Systems Survey Form by Standard Process

The System Survey is designed to assist you in communicating your health concerns and issues and to identify things that you may not think matter but help complete the overall picture of your health. The tool will assist with identifying which body systems are in need of support.
The System Survey is organized by body system not a diagnosis and each grouping represents the following:
Group One – Sympathetic Dominance, Group Two – Parasympathetic Dominance, Group Three – Sugar Handling, Group Four – Cardiovascular, Group Five – Liver/Gallbladder, Group Six – Digestion, Group Seven – Endocrine (Thyroid, Pituitary, Adrenals), Group Eight – B vitamin deficiency, Female Only, Male Only
The purpose of the System Survey is to identify “systems” which are in need of nutritional supplementation. Even if new “diseases” are identified, the systems of the body do not change. Usually, a disease has an effect on one or more systems within the body and this is what the System Survey is designed to identify to allow for a specific nutritional support that can be given to the underlying system. The purpose of the survey is to allow the patient to voice their perception of his/her symptoms. The symptoms listed on the survey are grouped to extract foundational problems within a system rather than focus on individual symptoms.
To fill out the Systems Survey Form use the link below. You can download the form, print it out to fill it out, and bring it in (or email it to us) or you can download the form, fill it out, then email us your completed form. Please note, if the question does NOT apply to you just leave it blank. 
Email: [email protected]
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   Formula 303​







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​Formula 303 is an all natural herbal remedy that harnesses the medicinal properties of valerian root, passion flower, and magnesium to provide you with relaxed muscles, stress relief, and natural relief from just some of the following: 
  • Muscle Pain
  • Muscle Spasms
  • Joint Pain Relief
  • Backache
  • Leg Cramps
  • Pulled Muscle
  • Neck and Shoulder Pain
  • Tension and Stress
  • PMS Cramps
  • Restless Sleep