Welcome to the Build a Better Brain Program!

We're thrilled to have you enrolled in the Build a Better Brain program! This comprehensive approach has been shown to be highly effective in preventing and reversing cognitive decline.

Program Overview:

• Introduction: Dr. David Allen will kick things off by presenting the latest medical research and trials on methods to reduce Alzheimer's risk and improve cognitive function.

• Personalized Plan: You'll receive a follow-up appointment to tailor the program to your specific needs. This may include ordering relevant lab tests.

  The keys of the program are:

• Diet for the Mind: Discover the optimal diet for the mind. Learn to distinguish good and bad fats for optimal brain function.

• Essential Supplements: Discover key supplements that can support cognitive health.

• Exercise: We'll guide you on incorporating aerobic, strengthening, and brain-training exercises to boost memory and focus.

• Optimizing Deficiencies: We'll address potential thyroid and insulin issues to ensure optimal brain function.

• Restful Sleep: Discover strategies to promote healthy sleep patterns, crucial for brain health.

• Avoiding Toxins: Learn how to reduce toxins in your water, air, and food for a healthier brain environment.

• Calming the Mind: Techniques will be provided to help manage stress and promote mental well-being.

Benefits:

By participating in this program, you can expect to:

• Reduce your risk of developing Alzheimer's disease

• Improve your overall cognitive function

• Enhance your memory and focus

• Promote better sleep and stress management

We look forward to helping you build a stronger, healthier brain!

Please complete the following and bring to the Clinic at your first session.

Name ___________________  Date of Birth ___________  Today date _____

Please list all of your medical conditions. 

1. _________________________________ 

2 _________________________________ 

3. _________________________________ 

4. _________________________________ 

5. _________________________________ 

6. _________________________________ 

List medical conditions in your family including cancer, diabetes, heart disease, et

 What medications, herbs, and vitamins/ supplements are you currently taking? Remember to include over-the-counter medicines.   

1. _________________________________ 

2 _________________________________ 

3. _________________________________ 

4. _________________________________ 

5. _________________________________ 

6. _________________________________ 

Allergies? Yes No   If “yes”, reactions? _________________________________________________________________________________________________________________________________________________ 

What (if any) physical activity/exercise do you engage in and how often? __________________________________________________

__________________________________________________

Describe you last 2 typical meals? ____________________________________________________

____________________________________________________

Circle any symptom have had

General

Fatigue 

HEAD

Headaches

Head injury

EYES

Change in vision

Double vision

EARS/NOSE/THROAT

Ringing in ears

Dizziness

Frequent colds

Hoarseness

NECK

Lumps

Goiter

ENDOCRINE

Increased thirst

Increased urine production

Thyroid trouble 

Diabetes or pre-diabete

RESPIRATORY/CARDIAC   

Shortness of breath   

Cough

Swelling in hands/feet

High blood pressure

Skipping heart beats

GASROINTESTINAL   

Change of appetite or

Weight

Constipation

Diarrhea

Change in bowel habits

Food intolerance

MUSCULOSKELETAL

Arthritis

Gout

NEUROLOGIC

Headaches

Memory problems

Seizures

Fainting

Weakness

Muscle spasm

Tremor

Numbness

HEMATOLOGIC

Anemia

Easy bruising/bleeding Past Transfusions

PSYCHIATRIC

Tension/Anxiety

Depression/suicide ideation

Sleep problems

Change in mood