Zinc Mini-Test Name* First Last Email* Do you suffer from: Lack of sense of smell Lack of sense of taste Increased susceptibility to colds, flu, or other infections Failure to grow or thrive Prostate problems, such as prostatitis or enlargement, possibly with urinary difficulty as in voiding Delayed wound healing Geographic tongue Enlarged facial pores None of the above Check all that apply.Do you have acne? None Mild Moderate Severe Do you consume refined sugars on a regular basis? Never Rarely Moderately Extremely Do you consume alcoholic beverages? Never Rarely Moderately Extremely
