Intake Record

To complete the lists below be sure to include the full range of items that you would consume over a month’s time.

What do you eat? Eg. condiments, snacks, spices.	What you drink? Eg. types of water.	Supplements Eg. greens mix, protein Supplements	Medications
What do you use on your body? Eg. hair, skin, mouth, feet, water. Type of shower or bath water?	What do you use to clean your clothing?	What products are used to clean your home/work/school environment?	What types of air are you breathing and electromagnetic energies you are exposed to? Eg. At home, work, commuting, school, shopping? Second hand scents?