Food Introduction Delayed Response Chart

Name:___________________________

Digestion/

Day

Food

Joint /muscle

Headache/

Nasal or Chest

Kidney-Bladder

Energy

Bowel function

aches

Pressure

Congestion

Skin Function

Level

time

food

Note: Please reintroduce only one new food at a time. Ingest it twice in the same day & then wait two full days to see if you have a reaction. Assess your response over

the next 48-72 hours. You may insert different headings on this chart to correspond with whatever signs or symptoms that you may display. Important indicators which

must be charted include: digestion, bowel function, and energy level. If you require more space use the back of this sheet and clearly mark the day, the food and your

symptoms. If you are unsure if you had a reaction, retest the same food in the same manner.