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Level II New Patient Questionnaire

Welcome !


Use this form if you are requesting Deep Health Analysis, and also requesting Level II Membership with BSI.

>>>> IMPORTANT: All appointments are fully booked through 17 June, 2019. Please submit your suvey now, however you may not be booked for an appointment before 17 June. Sorry for any inconvenience. <<<<


We strongly suggest you save the form each time before pressing 'Next" at the bottom of each section. If you loose internet service, you may loose your un-saved responses. Also the questionnaire will time out after 15 minutes of non-use. Just save it if you have to leave for awhile.


Level II is all about detoxifcation and rebalance of body systems. This is how we begin most therapies at BSI. You will be asked 76 questions regarding your health history. We will preform detailed analysis based in part on your detailed responses. Accuracy is key.


All Information Remains Confidential.


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