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Health Appraisal

Welcome to our online health appraisal system! This function is not designed as a method of treating disease; you will need a health care professional to assist you in your goals. This instrument is designed to assist you in your quest for better health by pointing you in the right direction to start rebuilding health and strength by natural means.

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Part I

Section A:

Burping

Fullness for extended time after meals

Bloating

Poor appetite

Stomach upsets easily

History of constipation

Known food allergies

White coating on tongue

Itchy anus or ears

Do you experience unexplained GI pain or discomfort, especially after food?

Does your bloating increase noticeably overnight?

Have you experienced an unexplained accumulation of fat around the midriff?

Section B:

Abdominal cramps

Indigestion 1-3 hours after eating

Fatigue after eating

Lower bowel gas

Alternating constipation and diarrhea

Diarrhea

Roughage and fiber causes constipation

Muccous in stools

Stool poorly formed

Shiny stool

Three or more large bowel movements daily

Foul smelling stool

Dry flaky skin and/or dry brittle hair

Pain in left side under rib cage

Acne

Food allergies

Difficulty gaining weight

Section c:

Stomach pains

Stomach pains just before and/or after meals

Dependancy on antacids

Chronic abdominal pain

Butterfly sensations in stomach

Difficulty belching

Stomach pain when emotionally upset

Sudden, acute indigestion

Relief of symptoms by carbonated beverages

Relief of stomach pain by drinking cream/milk

History of ulcer or gastritis

Current ulcer

Black stool when not taking iron suppliments

Section D:

Seasonal diarrhea

Frequent and recurrent infections (colds)

Bladder and kidney infections

Vaginal yeast infections

Abdominal cramps

Toe and Fingernail Fungus

Alternating diarrhea/constipation

Constipation

History of antibiotic use

Meat eater

Rapidly failing or blurry vision

White coating on tongue

Itchy anus or ears

Part II

Section A:

Intolerance to greasy foods

Headaches after eating

Light colored stool

Foul smelling stool

Less then one bowel movement daily

Constipation

Hard stool

Sour taste in mouth

Grey colored skin

Yellow in whites of eyes

Bad breath

Body odor

Fatigue and sleepiness after eating

Pain in right side under rib cage

Painful to pass stool

Retain water

Big toe pain

Pain radiates along outside of leg

Dry skin/hair

Red blood in stool

Have had jaundice

High blood cholesterol and low HDL cholesterol

Is your cholesterol level above 200

Is your triglyceride level above 115

Section B:

Swollen eyes (bulging)

Strong smelling urine

Thick skin and finger nails

Dry skin

Sensitive to the cold

Cold hands and feet

Excessive menstrual bleeding

Chronic fatigue

Trouble waking up in the morning

Depressed, apathetic

Low sex drive

Puffy, wrinkly skin

Sugar causes irritability and mood swings

Premenstrual tension

Constipation

Thinning or loss of outside protion of eyebrow

Gain weight easily

Anemia unaffected by iron

Axillary (armpit) temperature below 97.6 F

Slow reflexes

Infertility

Part III

Section A:

Sensitive to exhaust fumes, smoke, smog
and petrochemicals

Periodic constipation

Cannot tolerate much exercise

Depression or rapid mood swings

Dark circles under the eyes

Dizziness upon standing

Lack of mental alertness

Catch colds easily when weather changes

Headaches

Difficulty breathing

Water retention

Eyes sensitive to bright light

Feel weak and shaky

Part IV

Section A:

Pain in fingers

Bones: sore/painful

Eat meats

Cavities

Arthritis

Drink carbonated beverages/sodas

Gum Disease

Bone loss

Calcium deposits

Use antacids

Dentures

Bone deformaty

Told you have Osteoporosis/Osteomalacia

Recent bone fracture

Are you post menopausal

Are you: Male Female

Section B:

Muscle spasms

Tightness in shoulder muscle

Muscle cramps

Pain in arms, hands

Leg cramps at night

Stiff all over

Stiff in the morning

Unable to sit straight

Pain in neck and/or shoulders

Back pain

Section C:

Overflexible joins (double jointed)

Back pain

Swollen knees/elbows

Athletic injury

Bursitis

Tendonitis

Joint pain

Slipped disc

Herniated disc

Loss in height

Injure easily

Disclaimer: These formulas are not meant to treat disease but are to assist you and your treating physician in helping you to get well. They simply provide useful nutrients and support from the plant kingdom. All formulas contain plants from the FDA G.R.A.S. list.