Bubble Gum

Pure Gum Mints

Description

A naturally sweet twist on the classic flavour we all grew up loving.

Ingredients

xylitol, gum base, gum arabic, natural flavors, glycerol, malic acid, citric acid, carnauba wax, tocopherols.

About the Brand

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Practitioner Health Questionnaire

Name

Age

Gender Male Female

Primary Health Complaint

Describe your symptoms,including frequency and duration

When did they start?

Is there any thing that them better or worse?

Is there a family history of these symptoms ?

Diet and Life style

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What is the quality of your sleep(out of 10,where 10 is best quality)

General stress levels(out of 10,where 10 is the highest)

Overall diet(out of 10,where 10 is the healthiest)

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Please list any allergies you have.

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Medical History

Arthritis

Asthma

Chemical sensitivities

Coeliac disease

Diabetes

Epilepsy

Glaucoma

Heart Condition

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Inflammatory Bowel disease

Lactose in tolerance

Stomachulcers

Thyroid

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Supplements

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