New Client Forms

Thank you for your interest in Long Term Solutions, LLC.   We have been in business since 2010 assisting clients on their journey to long term health. During those years we have kept up to date in the most cutting edge clinical assessments and nutritional products available.  Our clinical assessments involved both subjective and objective forms of testing. As we continue to grow as a clinic we have added a host of other  assessments to better understand the underlying cause of the bodies dysfunction.   Some common types of assessment we use are Nutrition Response Testing SM, Bio Energetic Testing, and other forms of Functional Testing,

The overwhelming needs of our community have lead us to take a temporary pause  in accepting new clients. We are currently working on updating our systems for better client flow, interviewing other like minded health care professionals to establish more collaborative relationships, researching other areas of clinical interest, and looking for new office space.  Please accept our appologies for temporarily not being able to meet your current nutritional needs.  We would be more that happy to have you send us an email to discuss your unique situation.  We will call you back and either help to find you a local practitioner or put you on our Wait List.       We look forward to accepting to New Clients again soon.  

email:   ajourneytowellness@me.com

 

ON HOLD 

We look forward to the opportunity to evaluate your situation and partner with your on your healing journey. The first (2) visits consist of Evaluation and Report of Findings.   Evaluation includes: Consultation, Bio-Energetic Assessment, Nutrition Response Testing SM  Exam and other Clinical Data Collection. Report of Findings visit reviews the results of the Evaluation and  "Natural Health Improvement Plan". Both appointments are scheduled for approximately two hours each and on separate days. During these visit we welcome any questions or concerns you may have and will do everything in our power to get those addressed.

In preparation for the Evaluation visit, please Print and Complete the Forms below.  Once the Forms are returned to the office, we will schedule your (2) appointments and collect payment in Full.  Preparation for your appointment takes several hours and we find it more beneficial to start this process prior to your Evaluation.   The practitioner will review the Forms and research any pertinent data specific to your situation .  She also may email you with some follow up questions.  The Evaluation time can then be spent intentionally listening to your concerns and gathering various assessment data. 

PLEASE NOTE: Every question on these forms is important to your evaluation process, so please answer them accordingly. No section should be left blank. Not applicable (NA) should be used when no information is available.

Authorization Form 

New Client Information (Adult, Pediatric, or Pediatric Short Form) 

Bristol Stool Chart (Review)

Food Guidelines (Review) 

Food Log:  Review the Guidelines first, then complete the log as per directions.  Start completing your food log NOW, as it is a 3 day Food Log and needs to be included along with the other paperwork. 

Phytonutrient Spectrum Foods:  With a Red Pen, circle the foods that you currently eat.  With a Blue Pen, circle the foods that you are willing to try.

Symptom Survey- Complete the form in Black Ink, then write the number corresponding to your symptoms (mild, moderate, or severe )in the appropriate boxes in RED.

What Fills me up and What Drains me Handout (print and complete)

Evaluation $250.00 

 What else to include with your intial paperwork?

  • All  medications and supplements- whether they are taken every day or on a as needed basis. If this is a Clinic Visit, then bring ALL of them with you. If this is a Remote Visit, then you will need to take Clear Photos of the prescription label on your medications, and for supplements/over the counter medications you will need to take a PHOTO of the front AND the back of the bottles.
  • Copies or Scans of the results of any recent blood work, or other diagnostic testing (MRI, CT Scan, Xray, etc.).  They will be returned at the Report of Findings Visit.

We look forward seeing you soon.

 

 

Questions and Answers

The term Natural Health Practitioner includes a wide variety of practitioners who practice under various licenses or certifications.  These can include Nurses, Chiropractors, Massage Therapists, Acupuncturist, Nutritionist, and Naturopaths amoung others. Their approach to assessment is based on their clinical training or specialty but the general goal for treatment or support is to use a non surgical/non pharmacological approach to support the body’s physiology.

We are a Holistic Health Clinic specializing in various types of assessments including Bio-Energetic Assessment, Nutrition Reponse Testing SM, and other Functional Wellness Techniques.  We use homeopathic remedies and raw, concentrated whole food and whole herb nutrition to support the bodies biochemical and physiology processes.  We assess for and remove Stressors/Barriers that are acting on the body’s nervous system and interfering with the bodies ability to utilize nutrition and heal their tissues and organs.  

  Nutrition Response Testing utilizes Muscle Testing (applied clinical kinesiology) to assess the bodies neurological reflexes. 

Nutrition Response TestingSM uses the body’s own neurological reflexes and specific acupuncture points to assess the nervous system.  These reflexes are the nervous system’s way of communication with us energetically.  They are derived from the part of the nervous system whose job it is to regulate the function of  the body’s organs and systems.   Since the human anatomy has not changed significantly in thousands of years, these reflexes and acupuncture points have become extremely useful in our practice because they are so reliable!  These reflexes are tested on the surface of the body and then the findings are analyzed.

Nutrition Response Testing SM also provides a system of monitoring the body at each visit.  This has proven to be extremely accurate clinically to help us identify exactly what the body needs and how well we are meeting that need.

With Nutrition Response Testing SM , if the practitioner is using the muscle testing technique, one hand will be used to apply pressure to the client’s extended arm while using the other hand to touch various reflex areas.  The client will be asked to “match” the pressure the practitioner is putting on their arm, while the reflex is assessed.  

Some reflexes will remain strong when the practitioner contacts them (strength in the extended arm) while others will go weak (weakness in the extended arm).  Various homeopathic vials of stressors and nutritional concentrates/supplements will be assessed to determine which ones bring strength back to the weakened reflex.

The information collected during this exam will be incorporated with all the other data collected during the Evalution and a designed individualized “Clinical Nutrition Plan” will be created and reviewed  “Report of Findings” visit.

Currently, at Long Term Solutions, LLC our practitioner will use a Bio-Energetic Assessment technique which will use the bodies bio-energetic properties to assess the the organs and systems.

A “stressor” can be many things, but some of the most common stressors we find clinically have to do with the body’s inability to manage the removal of Chemicals and Heavy Metals, or the inability to balance the Microbiome (normal microbial balance in the gastro-intestinal tract and other organs and systems. Immune challenges often manifest symptomatically as “food Sensitivities” or difficulty with some aspect of digestion.   The presense of scars on the body can also present as a stressor.  

Please see the examples below in each category to learn more fully the stressors that can be acting on the body preventing it do perform as it was designed to do.

1.) Chemicals:

(acetate/tones) nail polish remover, paint thinners and removers
(chlorine) drinking water, swimming pools
(food colors) packaged foods, candy, medications
(formaldehyde) new building materials, carpets, Nutra Sweet, etc
(fragrances) perfumes, cleaning and other products
(hydrocarbons) exhausts

(colors, dyes) medications, food, supplements, clothing
(pesticides) herbicides, fungicides, insecticides (bug killers)
(petroleum solvents) skin care, laundry/housecleaning detergents, mineral oil
(plastic mix) food and water packaging materials
(preservatives) packaged foods, supplements

2.) Heavy Metals
        
Aluminum: cookware, antacids, antiperspirants, aluminum cans, kitchen utensils, paints, dental composites.

Antimony: found mostly in medications and pigments (toxic)

Arsenic: poisons, pigments, dyes, wood preservatives, insecticides, wine, well water, coal burning seafood (shell fish), treated lumber
 
Cadmium: water from galvanized pipes, evaporated milk, shellfish, cigarette smoke, sewage sludge, paint, pigments, air pollutions

Chromium: dyes, pigments, air pollution, dental crowns

Copper: copper plumbing, sewage sludge, beer, swimming pools, copper cookware, inorganic mineral supplements, dental crown

Gold: dental fillings, jewelry, injections for arthritis

Iron: dyes, inks, paints, pigments, poor inorganic mineral supplements in food

Lead: car exhaust, paint, plumbing, canned food, hair dyes, newsprint, tap water

Manganese: ceramics, antiseptics, dyes, medicines, steel products, air pollution, water supply

Mercury: dental fillings, seafood, polluted water, skin lightening creams, sewage sludge, vaccinations

Nickel: cigarettes, cental crowns/retainers/fillings, hypoallergenic earrings

Silver: dental fillings, Jewelry

Tin: canned foods

Titanium: pigments in paints, preservatives in medications, tap/well water, dental crowns/implants

Zinc: poor quality Inorganic supplements in food

3.) Immune Challenge:

Unhandled stressor on one or more of the Immune Organs involving:

Virus
Bacteria
Fungal/Yeast
Parasite

4.) Food:

Grains: Wheat, Corn, Oats, Barley, Rye, White Rice, Brown Rice “sprouted grains”, etc

Dairy: Milk, Raw Milk, Cheese, Cheese Mixes etc
    
Eggs: Egg White, Yolk, Organic eggs, commercial eggs etc
    
Sugar: Processed sugar (bleached white, brown), Honey, Fruit

5.) Scars:   

Scars can form any time the skin is cut, such as in past surgeries or trauma. Common scars come from immunization/vaccinations, tattoos, pierced body parts, chicken pox/lesions, episiotomy/c-section, circumcision, tooth extractions, tonsillectomies, stretch marks, umbilicus, and any other scar on the skins surface.  

Scientific research exists to support that any area of the skin that heals by scar formation has increased sympathetic nerve innervation.  These scars can accumulate nerve energy and discharge at any time in an uncoordinated fashion causing stress on the nervous system.

6). Other Stressors:

medications
jewelry
medal body piercing Jewelry
q-link pendants and other similar items
cell phones and pagers
magnetic items (orthotics, strips on drivers license/credit cards)
metal under-wire bra’s (if they pinch off the lymphatic drainage)
black clothing/synthetic materials
dental problems (infected areas of jaw bone from failed root canals, other TMJ-    dysfunction
acute psychological stress
acute injuries

The word “laser” is an acronym for Light Amplification by the Stimulated Emmision of Radiation. 

Low - level laser light (cold laser) is compressed light of a wavelength from the cold, red part of the spectrum of electromagnetic radiation. It is different from  natural light in several ways:  it is one precise color; it is coherent (it travels in a straight line), monochromatic (a single wavelength ) and polarized (it concentrates its beam in a defined location or spot).

These properties allow laser light to penetrate the surface of the skin with no heating effect, no damage to the skin and no known side effects. Rather, laser light directs bio-stimulative light energy to the body’s cells, then converts it into chemical energy to promote natural healing and pain relief.

Cold laser light therapy used over injuries or wounds improves soft tissue healing and relieve both acute and chronic pain.  The therapy is precise and accurate; and offers safe and effective treatment for a wide variety of conditions.

The first appointment is for gathering important information.  Various non-invasive tests will be performed and the practitioner will review the history and symptoms with the client. A Bio-Energetic Exam along with a Nutrition Response Testing  (SM) Exam will be completed.  Various nutritional supplements will be evaluated to determine which ones bring the body back in balance.  The practitioner will review all the data collected from this visit and any further research needed, then develop a "Natural Health Improvement Plan".    The results of this Plan will be discussed at the second visit called the “Report of Findings” visit.

 

At the Report of Findings visit, the practitioner will discuss the results of the "Natural Health Improvement Plan"    This Health Plan often includes temporary removal of some food allergens. This helps support the immune system’s recovery which can be adversely affected by these allergens.  Often times, once the immune system stress is handled, the foods no longer create stress on the body. Other behavioral changes may be recommended and revolve around sleep, stress management, clean water, exercise, sunshine, gratitude and forgiveness.  

Supplements are also included in the "Natural Health Improvement Plan".    These supplements are the ones identified during the exam that brought balance to the organs and systems.  These nutritional components were either missing from the diet, or were unable to be fully utilized in the current health state.  The Plan will address those issues.  Spouses or significant others are encouraged to be present at this appointment for education and support.  

A "Individualized Nutrition Program" is part of the Natural Health Improvement Plan and utilizes concentrated whole food/herb in a tablet/capsule/or liquid.  They are prepared using a process that preserves all of the active enzymes and vital components that make them work as Nature intended. These real food/herb supplements have been designed to specifically match the needs of the body. This part of the Plan does not consist of 'over-the-counter' vitamins. Over-the counter vitamins are pharmaceutically produced in a laboratory and are rarely derived from whole foods/herbs, often causing you to be even more deficient and nutritionally out-of-balance.

Many clients see symptom improvements in a little as 4-6 weeks. However, chronic health problems do not develop overnight.  Tissue and cellular healing takes time, but the benefits are well worth the effort. The sooner the Natural Health Improvement Plan is fully implemented, the sooner the body will begin to heal and symptom relief will become more obvious.


The Autonomic Nervous System (ANS) is the involuntary division of the Central Nervous System.  The ANS controls all the automatic functions in the body; blood vessle contraction/relaxation, hormone release, biochemical reactions, waste removal etc.  Their function is dependant on nutrients.  Bio-Energetic testing focuses on the functional health of the ANS and the Stressors that may be affecting its function.

The terms “Blocking and Switching“ are two terms you may hear during the Report of Findings Visit and follow up visits and can create a little bit confusion.  In very simple terms, the ANS has two parts of the system that need to be in communication with each other constantly to regulate  all the biochemical processess of the body.  

Sometimes these two systems get confused “switched” and do the opposite of what they were designed to do and other times there is a “block” in the system and the abililty to respond appropriately is lost.  Both of these situations interfere with the body’s ability to heal itself.  The terms "Gas Pedal and Break Pedal" will be used to refer to these parts when discussing the function or dysfunction at follow up visits.

 

The Health Express is a fully automatic, non-invasive computer-based system designed to assess physical fitness and the functional balance of the autonomic nervous system (ANS).   

The Health Express is used both as a baseline indicator and to evaluate the progress of a program.  The body’s physioloigcal stress can be measured as well as its adaptive capabilities.  This test is most helpful to view in comparison to previous tests over time.  Several will be performed during the course of the nutrition program.

Yes.  The deficiencies or imbalances that have accumulated over the years and led to a breakdown in resistance, or imunity is what has fueled the current health challenge.  The good news is with the right nutritional program it is possible to reverse that process.  

Each cell, tissue,and organ in the body is in the process of repalcing itself every day.  The "Natural Healh Plan" provides exactly what the body needs to repair, replace, & restore itself naturally.  Using Bio-Energetic Assessmsents and Nutrition Response Testing SM assists us objectively in determining what will help bring the body back in balance.



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