Kingston Integrated Healthcare

Self Assessment Tools


We’ve gathered some health questionnaires and self-assessment tools to offer insight and guidance in your work with your healthcare provider. Please do not use them to diagnose or treat your health concerns.

Where Do I Start?

Integrative Intake Screening Questionnaire

It can be challenging to find the healthcare approach that best suits your health concerns and belief system. We’ve created this questionnaire to help guide you in your decision. For more support, please submit your completed form to our reception staff for review by our Clinic Director, or schedule an introductory consultation with one or more practitioners in our facility.

Stress Questionnaire

This Perceived Stress Scale (PSS) is a health tool commonly used by health professionals to explore how much stress clients feel in their day-to-day life. Higher scores on this stress questionnaire are correlated with many health concerns, including depression and vulnerability to cold viruses. The good news is that PSS scores can improve quickly – in as few as 4 to 8 weeks! If your life stress is high, consider using this questionnaire to monitor how well you’re doing every couple of months, after you’ve implemented some important life changes.

Optimism Optimism

The Optimism Test

Can you prevent depression and anxiety? The research says that yes, sometimes you can! By practicing the skill of optimism.

How we think about bad events, matters. Many healthy people and critical thinkers unknowingly tend toward pessimistic thinking and this is a known risk factor for depression. Further, cultivating the skill of optimism is protective against depression. Are you naturally a more optimistic or pessimistic thinker?

This optimism test, provided by Dr. Marty Seligman, a Positive Psychology researcher and professor at the University of Pennsylvania, is a good place to start! 

Occupational Burnout Occupational Burnout

Occupational Burnout

Burnout in the workplace can show up as exhaustion, loss of empathy for colleagues, and feeling like a failure. This is often considered to be different than depression. Use this validated Maslach Burnout Inventory (MBI) to explore whether you’re at risk for burnout.

Lyme Disease Screening & Symptom Questionnaire

Chronic Lyme Disease symptoms are often widespread, non-specific, and unique to the individual experiencing the illness, making it one of the most challenging infections to accurately diagnose and treat. To help your Naturopathic Doctor make an accurate diagnosis, please complete this Lyme Screening Intake Questionnaire and the empirically-validated Lyme-MSIDS Symptom Questionnaire created by Dr. Horowitz and posted on the Lyme Ontario website. The new “General Symptom Questionnaire-30”, available in this research paper, might also be a useful tool.

Environmental Health Questionnaire Environmental Health Questionnaire

Environmental Health Questionnaire

If you find that your threshold for tolerance to environmental chemicals is declining, you’re not alone. Some people find that it starts suddenly after a significant illness or stress like Lyme disease or a car accident. Sometimes the chemical sensitivity progresses gradually to include EMF sensitivity or mould (mycotoxin) intolerance.  We have many tools to help your body get back on track with improved chemical tolerance! Reducing exposure is the first step. 

Electromagnetic Fields Checklist

Electromagnetic fields (EMFs), such as what cell phones and wi-fi internet routers emit, are a health risk. Even transient exposure causes symptoms in as much as 8% of the population. Which symptoms? How high is your exposure? Use this assessment to explore how this environmental contaminant impacts your health.

Mould and Mycotoxins Mould and Mycotoxins

Mold and Mycotoxin Illness

Fungus is a healthy part of our bodies and microbiome. However, some environmental molds generate toxic chemicals (mycotoxins and volatile organic compounds) that trigger allergic reactions, toxic responses, and immune system dysfunction. 

These molds grow in areas of your home where water damage has occurred (where eaves were blocked, pipes have burst, or basements have flooded, for example). They grow in humidifiers, can be spread by ductwork, and persist long after remediation occurred. 

Symptoms can mimic many other illnesses and inhibit healing from complex, chronic illness. This questionnaire will help us decide whether further testing is warranted.

Heavy metals Heavy metals

Heavy Metal Exposure Screening

All of us have been exposed to some degree, to heavy metals. These include naturally-occurring arsenic in ground water, lead waste from industry, cadmium from cigarette smoke, and mercury in fish.

Health concerns resulting from a high body burden of metals are vast and variable, including increased risk of heart disease, neurological disease, and cancer. Ongoing research continues to shed light on this area so that the underlying cause of many health conditions can be treated more effectively.

Healthy Genes Self-Assessment

Does your lifestyle and nutrition support your unique genetic makeup? Are your “healthy” choices preventing chronic disease, or unknowingly contributing to it? Learn which personality traits and health concerns are linked to poorly functioning genes, and use this self-assessment tool to help guide treatment recommendations from your healthcare provider.

Blood Sugar Imbalance Health Check

Your body works hard to keep blood sugar levels in check. When the struggle becomes too much or goes on for too long, we can have difficulty losing weight, experience overwhelming fatigue, and be challenged to overcome sugar cravings. We may eventually develop serious health conditions, such as metabolic syndrome, pre-diabetes, and diabetes. Use this self-assessment as a tool to explore whether your sugar levels are in balance.


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We respectfully acknowledge that Kingston Integrated Healthcare is situated on ancestral Anishinaabe and Haudenosaunee Territory. Since time immemorial they have cared for these lands and waters, and we are grateful. We recognize that a healthy environment is essential to the wellbeing of all people and all life.

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