spring Detox EXPOSURE Profile

Getting Started

The purpose of this questionnaire is to help you identify day to day patterns of exposure to potentially harmful substances in your general environment and lifestyle. The questions are designed to take an objective inventory of the types of substances you are exposed to most often, and whether there is a correlation to current health concerns.

You will have the opportunity to define some of your values and goals as it relates to your environmental health. The information you provide will be used to create an ‘exposure profile’ that you can use to fuel steps towards positive change. Your exposure profile can also become the basis of a personalized detoxification program offered by Urban Healer, which would include herbal medicine targeted to your specific needs and a step-by-step strategy to reduce key exposures in your diet and lifestyle.

In the questions below, you will be asked what non-toxic consumer products you currently use. Please read our definition of a non-toxic consumer product before answering the questionnaire:

What is a non-toxic consumer product?

A non-toxic consumer product is free from chemicals of concern that may pose a risk to human health. Chemicals of concern are allergens, carcinogens, endocrine disruptors or neurotoxins that have been associated with reproductive, developmental, immunological, cognitive or endocrine health disorders.

Name *
Name
1. I am concerned about how my health may be impacted by daily exposures to multiple chemicals, food additives and pollutants.
1. I am concerned about how my health may be impacted by daily exposures to multiple chemicals, food additives and pollutants.
2. I believe that Health Canada regulates the chemicals in consumer products and is ensuring these products are safe for the public.
2. I believe that Health Canada regulates the chemicals in consumer products and is ensuring these products are safe for the public.
3. I believe that harmful man-made chemicals can persist in the environment and accumulate in the fat tissue of humans, animals and wildlife.
3. I believe that harmful man-made chemicals can persist in the environment and accumulate in the fat tissue of humans, animals and wildlife.
4. I believe my body can detoxify all of the chemicals and pollutants I am exposed to on a daily basis without any additional support.
4. I believe my body can detoxify all of the chemicals and pollutants I am exposed to on a daily basis without any additional support.
5. Which of the following personal care products do you currently use?
Check all products that apply.
7. Which of the following household products do you currently use?
Check all products that apply.
9. Which of the following foods or beverages do you typically purchase in plastic bottles?
Check all that apply.
15. Which of the following foods are part of your regular diet?
Check all that apply.
17. Do you use enteric-coated / time-release medications or supplements on a regular basis?
18. Do you use imported herbal supplements manufactured in China or India on a regular basis?
19. Which of the following substances do you consume on a regular basis?
Check all that apply.
21. How has your indoor environment changed in the last 3 years?
Check all that apply.
23. Which of the following substances are you regularly exposed to in your home or work environment?
Check all that apply.
24. Check any reactions you have to any of the exposures listed above:
Check all that apply.
25. Do you work in any of the following occupational fields?
Check all that apply.
27. Do you live or work in close proximity to any of the following:
Check all that apply.
28. Have you had prolonged exposure to wildfire smoke in the last 3 years?
29. Which of the following health conditions are you personally most concerned with?
Check all that apply.
31. Which of the following health symptoms are you personally concerned about?
Check all that apply.
33. In what areas of your lifestyle would you like to implement non-toxic solutions?
Check all that apply.