SprintSet Body Assessment

Please indicate rating of symptoms experienced in the last 90 days.

All Symptoms must have a response

Head

Headache, Forehead

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Headache, Back of Neck

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Migraines

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Faintness

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Dizziness

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Lungs

Chest Congestion

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Asthma

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Bronchitis

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Shortness of breath

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Difficulty Breathing

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Immune

Stuffy Nose

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Sinus Pressure

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Fever

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Coughing

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Achiness

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Skin

Acne

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Dry, Scaly Skin

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Hair Loss

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Flushing

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Excessive Sweating

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Allergies

Itchy, Watery Eyes

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Reddened Eyes

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Runny Nose

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Swollen Eyelids

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Sneezing

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Digestion

Nausea, Vomiting

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Diarrhea

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Constipation

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Heartburn

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Bloating, Belching, Gas

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Mood

Mood Swings

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Anxiety, Nervousness

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Anger, Irritability

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Aggressiveness

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Depression

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Joints / Muscles

Stiffiness/Lack of Motion

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Arthritis

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Pain in the Joints

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Pain in the Muscles

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Feeling of Weakness

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Mind

Poor Memory

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Confusion

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Lack of Concentration

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Difficulty Making Decisions

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Learning Disabilities

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Weight

Binge Eating/Drinking

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Craving Certain Foods

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Excessive Weight

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Water Retention

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Overweight

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Energy Levels

Fatigue

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Restlessness

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Insomnia

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Unable to get to sleep

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Unable to wake up

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Heart

Irregular Heart Beat

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Rapid Heart Beat

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Chest Pain

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

Low Blood Pressure

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

High Blood Pressure

Never
Occasional / Mild
Occasional / Severe
Often / Mild
Often / Severe

You have completed your assessment!

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