1 .
Contact Information (Confidential)
Name
Email
2 .
Do you drink water?
3 .
Do you have acid reflux?
4 .
Do you have joint pain or arthritis?
5 .
Do you have gout?
6 .
Do you suffer from migraines or frequent headaches?
7 .
Do you have diabetes and sores that won't heal?
8 .
Would you like to talk with me more about your water and conditions?