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Functional Diagnosis Forms

Thank you for your interest in getting an in-depth report on your patients' blood test results or signs and symptoms analysis. You will need to download the following forms and have your patient fill them out.

Please e-mail me at or call my office in the US at 541-631-8316(PST) so I can give you information on how to pay for the consultation, and how to get the results to me. I look forward to hearing from you.

For details of the kinds of reports I do and the charges please send a blank email to:

Diagnostic Forms Download Intructions

  1. Simply click on the link below for each item you want to download. Note: Some files may simply open in your browser. If you want to avoid the file opening, just right-click and select Save Target As...

  2. If prompted, choose to Save file. Click Save and the file will be saved to your desktop or other location of your choice on your computer.

Nutritional Assessment Questionnaire
Download File:symptom-questionnaire.pdf

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Blood Chemistry Analysis Form
Download File:

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Weatherby & Associates, LLC
555 Mesa Dr.,
Ojai, CA 05048
Phone: 541-482-3779


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