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Fill questionnaire

Heshoutang online patient symptoms analysis form

Please fill out the questionnaire below carefully to the best estimation of your health situation.

Heshoutang Experts will conduct personal assessments based on the proved effective and safe Heshoutang Natural Health System.

The assigned Heshoutang Member will provide a reply within 24 hours since you submitted the questionnaire.
personal info

Let’s get to know each other!

Please fill out the fields below with your personal information. Make sure all the information you provide is correct.
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personal info

Spleen & Stomach:

Please read the categories below and choose the relevant box.

Appetite

Stomach Pain

Around Belly Button

Stomach Bloating

Burning Stomach

Acid Reflux

Taste in your mouth

Vomiting

Often Thirsty

Easily hungry

Prefer foods

personal info

Lung & Large Intestine:

Please read the categories below and choose the relevant box.

Cough

With Phlegm/Mucus

Asthma

Nose Problem

Throat Problem

Easily Sweating

Skin problems

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Kidney & Bladder:

Please read the categories below and choose the relevant box.

Sore Pain

Sharp Pain

Urine

Urine Color

Urine Frequency

Stool Problem

Sex Desire

Erectile Failure

Sex Time

Infertility

personal info

Liver & Gall bladder:

Please read the categories below and choose the relevant box.

Body Sides Suffering

Easily angry

Anxiety & Depression

Numbness

Shaking Body

Headache

Eyes problem

Vertigo

personal info

Heart & Small Intestine:

Please read the categories below and choose the relevant box.

Palpitation

Arrhythmia

Chest Pain

Insomnia

Dreamful

Dizziness

Heart attack history

personal info

For women only:

Please read the categories below and choose the relevant box.

Menstrual Cycle

Menstrual Duration

Menstrual Amount

Menstrual Cloth

Menstrual Color

Painful Period

personal info

Other problems:

Please read the categories below and choose the relevant box.

Calculus(Stone)

Hair Problem

Joints Problem

Face Color

Body Temperature

Edema

Teeth Problems

Ulcer

Hernia

personal info

One last step:

Please fill out the fields below with your personal information. Make sure all the information you provide is correct.

Before you go...

Heshoutang does not diagnose or prescribe, nor is it our purpose to replace the services of your doctor or traditional medicine. We offer information along with our products and suggested wellness programs to those who are willing to share responsibility for their own health with their physicians. In the event our client uses this information, and goes off their prescriptions without the approval of a physician, he/she assumes full responsibility for it.
It should not be misconstrued to mean, imply, or indicate that the products or programs described cure anything, as no such claims are made. ONLY THE BODY CAN HEAL ITSELF, so the dietary supplements are not offered as a cure, but rather as aids to the body in re-establishing normal functions. The body is very complex, and providing a clean diet and one hundred percent nutrition can optimize one’s health. Results may vary.
If your doctor indicates that dietary supplement is not important and attempts to treat you with drugs only, we suggest you obtain a second opinion from a diet conscious physician who is more aware of natural methods of biological medicine, because - after all – it is your health!