Health Needs Survey

Are you ready to finally heal so you can thrive?

The team from Budesonide Works, Defense Boxes, and Come Alive Institute want to best serve you as we are getting many requests for additional information and assistance with lingering issues from Covid as well as side effects of the shot or spike protein. None of this information will be shared with any third party. It is just for our own research so we may best assist you in your continued healing. We are working on solutions, products and programs to help all of us heal and thrive to be our best selves.

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* 1. How did you get to this survey?

Budesonide Works Website

Come Alive Institute Website

Defense Boxes Website

Through en email from one of the above entities

Other (please specify)

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* 2. Which of the following statements ring true for you? (check all that apply)

I feel betrayed or disillusioned by the medical establishment

I want to take charge of my physical & emotional health

I am ready to detox - physically, emotionally, energetically, spiritually, socially

I am tired of feeling worn out and helpless

I am ready to shed my stress and begin to really live again!

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* 3. First Name

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* 4. Email

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* 5. Are you vaccinated? If so, how many shots? (this is important so that we can make sure we have solutions for everyone)

Not Vaccinated (no shots)

One shot

Two shots

Two shots + booster

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* 6. Do you live with or spend a lot of time around someone who is vaccinated?

Yes

Other (please specify)

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* 7. Have you ever had Covid (either positive test or symptoms)? And if so, do you have lingering symptoms or issues.

Yes I had Covid but no lingering symptoms

Yes I had Covid and still have lingering issues

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* 8. Which of the following lingering symptoms or issues are you currently struggling with? (Check all that apply)

Lingering cough

Lingering breathing issues (wheezing, shortness of breath, hard to take deep breaths)

Find it hard to climb stairs or exercise

Endurance issues (for example, you can't run or workout like you used to)

Lingering sinus issues (congestion, sinus pressure, sinus headache)

Lingering mucus in throat (like a frog in your throat)

Low-grade fever

Gastrointestinal issues (diarrhea, gas, bloating, constipation, etc.)

Lack of hunger, not wanting to eat

Lack of sense of taste and/or smell

Weight loss

Weight gain

Sudden heart issues

High blood pressure

Rapid heartbeat (especially at night)

Dental issues

Aggressive cancer appearing out of nowhere

Pain and stiffness in lower back, hips, pelvis

Pain in legs, knees and/or calves

Overall joint issues

Swollen belly

Auto immune or inflammatory issues

Migraines

Frequent headache

Occasional headaches

Dizziness

Brain fog, confusion or memory issues

Other neurological issues

Ringing in the ears

Hair loss

Blood clots

Menstrual issues (like period stopped or started again if in menopause)

Issues with reproductive organs (either male or female)

Swollen glands

Strokes

Paralysis in face or one side of body

Muscle spasms

Skin rashes

Bruising

Swelling of the eyes and face

Eye or vision problems

Extreme fatigue

Feeling tired in the afternoons

Insomnia (hard time falling asleep or staying asleep)

Emotional rollercoaster (easily get angered, then sad, depressed)

Struggling with anger issues

Struggling with anxiety, fear or worry

Struggling with feelings of sadness and loss

Struggling with depression

Struggling with lack of drive or motivation

Other (please specify)

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* 9. Would you be interested in any of the following? (check all that apply)

A support group that meets weekly to help you figure out solutions

A formal program to go through to help heal these issues (with a practitioner or wellness expert leading it)

Working 1x1 with a trusted doctor, holistic practitioner, or wellness coach to tackle these issues

Access to information, products, solutions and resources to help you figure it out on your own

Other (please specify)