Body Type for Weight Loss Do you have any of the following symptoms "*" indicates required fields Step 1 of 16 6% General Information This survey takes approximately 2 minutes to complete. Thank you for your participation!Email* Name* First Last Swelling of the face or eyelids in the morning, or feeling of swelling when pressing on feet or between finger* Once a week or more No In the morning, can see a white and sticky tongue coating or feeling of phlegm blocking the throat.* Once a week or more No The stool is wet and sticky, easily adhering to the toilet.* Two times a week or more No This field is hidden when viewing the formWeak Digestive System Fear of heat, mouth easily cracks, face is oily, and prone to acne.* Has at least one symptom No Easily experiences bitterness in the mouth, or dryness and parched tongue, or has bad breath.* Has at least one symptom No Large appetite, or easily hungry, or eats too quickly (finish a full meal like dinner in less than 20 minutes)* Has at least one symptom No This field is hidden when viewing the formProne to Inflammatory Responses The complexion appears dull or pale yellow, has freckles, light brown, dark brown, dot-like or patch-like spots* Has at least one symptom No Often stays up late pass 11 pm or lies in bed for more than thirty minutes before being able to fall asleep.* Two times a week or more No Often experiences at least five of following symptoms:* Irritability Easy Anger Anxiety Insomnia Frequent Dreams Easy Awakening Eye Fatigue Dryness Discomfort Headache Dizziness Migraine Frequent Urination Lack Of Sexual Drive Lack Of Concentration Tinnitus Decline In Memory Abdominal Bloating Often Constipated Or Diarrhoea Excessive Stomach Acid Or Gastroesophageal Reflux Stiffness And Soreness In Shoulders And Neck Palpitations Chest Tightness Difficulty Breathing Smoothly High Blood Pressure Or Fluctuating Greatly Excessive Sweating Or Lack Of Sweating None This field is hidden when viewing the formProne to Stress The complexion is rather pale, or the nails and lips are pale in color, lacking in vitality or have anemia.* Has at least one symptom No Poor blood circulation, easily experiencing cold hands and feet, or feeling very cold.* Has at least one symptom No Easily feeling tired, fatigued and weak* Yes No This field is hidden when viewing the formWeak Qi and Blood Feeling sensations of swelling in the lower body* Yes No Easily catches a cold (more than two times per year). Or has an allergic constitution, such as allergic dermatitis, asthma.* Yes No Frequent urination, more than two times in the night time, urine is clear with no obvious odor.* Yes No This field is hidden when viewing the formProne to Water Retention
