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 Skin Rash

 Beauty/Hair

 Fertility

 Virility/Libido

 Cancer Recover

 Stress/Sleepless

 Flu/Cough

 Joint Pains

 Allergies

 Digestive

 Low Energy

 Delay Aging

 Detox

 Menstrual

 Weight Control

 Hemorrhoid

 

Questionnaire for assessing your physical constitution

Name:

Email address:

City, State/Country:

Year of birth:

Weight:

Male or Female:

List the health problems that bother you most in descending order:

Do you think you are eating healthy food?

Good appetite? Any food you tend to eat too much?

Do you have a long list of food you are allergic to?

Sleep ok? Easily disturbed in your sleep?

Are you active or do you exercise enough everyday?

Do you have any bad habits that may impact your health?

Good energy in the morning? Can you recover easily after some rest?

Used to feel cold, especially hands and feet?

Are you impatient? Can you bear standing in line?

Do you have high blood pressure, high cholesterol, or diabetes?

Do you take prescription drugs regularly? What kind?

Any other problems you want to share?

 

Please copy and email the completed questionnaire to: askjohnfung@gmail.com

John will reply to your email as soon as possible.

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