CKD Root Cause Questionairre

First name

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Health History

Have you been diagnosed with kidney disease? How long ago?

Please describe your journey. What recommendations have you been given?

What are your current medications, vitamins or supplements?

What has been your biggest struggle navigating your kidney disease diagnosis?

Have you ever tried any diets, lifestyle changes, or alternative therapies? Can you describe please.

What do you think is at the root cause of your kidney disease? (Why did you get it?)

The Kidney Care Blueprint is an online program, with online materials to access, and online Zoom calls for meeetings. How proficient are you in navigating online resources??

The Kidney Care Blueprint is an evidence based coaching program, which means it's based on scientific research studies of others with chronic kidney disease. It does not take the place of your medical doctor's advice. Any questions?