Welcome to Dr. Rettner's
"Total Body Makeover Program"
Trouble Losing Weight?
4 Phases
of Weight Loss
Weight Loss
Center
Weight Loss Forms
(These forms are available to download and print as .pdf files with
Adobe Acrobat 6.0 or later—
click here to download the latest version for Mac OSX;
click here to download the latest Windows version)
Please download and complete
these forms before your first appointment:
(To download click on each yellow link and save to your computer.)
 

B (Before your 1st appt.) Click here to download all 5 forms together. Bring these with you to your first appointment.

 
The 5 Individual New Patient Forms

• Find the Cause of Your Weight Problem—Body Shape Quiz

• Weight Loss Difficulty Questionnaire

• Most Commonly Reactive Foods

• Body Mass Index

• Metabolic Assessment Form (MAF)—complete sections VI & VII only

Weeks 1–8: Complete Program

•C (Complete 8-Week Program - Click here to download 1 single pdf)

Individual pdfs for 8-Week Program
Week 1

• Stapling Instructions for pdfs

• Diet Diary (make 8 copies)

• Hunger Is All in Your Head

• Neurotransmitter Assessment Form (NTAF)

• Glycemic Index

• Blood Test Instructions

• Insulin Resistance Evaluation

Week 2

• Eight Physical Causes of Weight Problems

• Liver Enhancement Program

Week 3

• QRA Nutrition Testing Chart (don't fill out)

• First Time Evaluation

• Balancing pH

Week 4

• Metabolic Type I

• The Blood Sugar Diet

Week 5

• Metabolic Type II
Week 6

• Metabolic Type III—Chinese 5 Elements Questionnaire

• Chinese Five Elements Diet
Week 7

• Metabolic Type IV—Ayurvedic Body Type Evaluation

• Ayurvedic Diet
Week 8

• Eat and Avoid List
Special Diets

• SD_A-O

• SD_TL

• Dr. Stone's Purifying Diet

• Changes that Occur During the Purifying Diet