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ABOUT
WHAT WE OFFER
OUR SERVICES
LEGAL PROFESSIONALS
EXECUTIVE WELLNESS
HIGH NET-WORTH INDIVIDUAL
COURSES
I WANT TO RESTORE MY GUT
I WANT TO REGENERATE MY HEALTH
I WANT TO OPTIMIZE MY HEALTH & PERFORMANCE
VIEW ALL PROGRAMS
SHOP
FEATURED PRODUCTS
VITAMIN C ASCORBATE
HEALTHY HAIR
MEDICINAL CBD
SUPPLEMENTS
SUPERFOODS
ARTICLES
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Dry Mouth Questionnaire
Dry Mouth Questionnaire
Δ
First Name
Last Name
Medication Use: Are you currently taking any other medications (e.g., antihistamines)?
Yes
No
Text Input
Do you have other symptoms like burning in your mouth or difficulty swallowing?
Yes
No
How much water do you drink daily?
- Select -
0,5 litre
1 litre
1,5 litres
2 litres
2,5 litres
> 2,5 litres
Are you using mouthwashes that contain alcohol?
Yes
No
Do you consume salty, sugary, or caffeinated foods and drinks more often?
Yes
No
Do you notice signs of dehydration like dry skin or dark urine?
Yes
No
Do you breathe through your mouth while sleeping?
Nose
Mouth
Questions to Determine if Uncontrolled and Elevated Blood Sugar is the Cause
Have you been feeling excessively thirsty lately?
Yes
No
Are you urinating more frequently than usual?
Yes
No
Are you experiencing unusual fatigue or lack of energy?
Yes
No
Have you noticed blurry vision recently?
Yes
No
Have your blood sugar readings been higher than your target range recently?
Yes
No
Don't know
Comments or Further Questions
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