Calcium Mini-Test Name* First Last Email* Which of the following apply to you? Joint pain Joint deformity History of arthritis in multiple areas Slow pulse rate Nervousness or irritability Twitching muscles and/or leg cramps Anxiety Aching deep in the bones Vulnerability to fractures Loose teeth Tendency to form cavities Brittle nails High blood pressure Soft teeth History of colon cancer Vertical ridges on the nails History of osteopenia None of these apply Do you get little or no exposure to sunlight?* Yes No Do you suffer from ulcerative colitis or Crohn’s disease?* Yes No Do you get little or no exercise?* Yes No Are you currently bedridden and/or wheelchair-bound?* Yes No Do you rarely eat Vitamin D rich foods?* Yes No Vitamin D rich foods: liver, eggs, butter, cream, cheese, fatty fishDo you consume refined sugar on a daily basis?* Yes No Do you have a history of osteoporosis?* Moderate Severe No
