This worksheet is offered to the client as he/she begins creating a personalized elimination diet.

The worksheet allows space for the client to organize potential triggers (e.g. fatty foods, lactose, gluten grains, sugar alcohols) to their symptoms. Suggestions/ideas are provided in the instructions of the worksheet.

The client lists out all potential triggers, provides a detailed description as well as a note about the reaction the trigger produced.

Once this handout is completed by the client, it can be used to help figure out which foods to include and which foods to remove during their elimination diet.

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