Optional · Clinical Nutrition
Metabolic Assessment Form
This detailed questionnaire helps Dr. Caroline identify patterns related to digestion, hormones, blood sugar, adrenal health, and more. Complete it at your own pace and email it back before your appointment.
1
Download the form
Click below to download the Metabolic Assessment as a PDF. It covers all 21 symptom categories and takes about 10–15 minutes to complete.
↓ Download Metabolic Assessment2
Fill it out
Print and complete the form by hand, or fill it out digitally in Adobe Acrobat Reader (free) or your PDF viewer of choice. Rate each symptom from 0 to 3 and answer the lifestyle questions in Part III.
3
Email it back
Send your completed form to admin@gracechirotx.com before your appointment so Dr. Caroline can review it ahead of time. You can also bring a printed copy with you.
Not sure if you need this form? The metabolic assessment is optional and most useful if you are interested in nutritional support, have digestive concerns, hormone imbalances, or chronic fatigue. If you have questions, call us at (817) 251-9828 and we can help you decide.