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 QUESTIONNAIRE - START 


"Without doubt the most in-depth diagnostic tool at my disposal. As a holistic MD, I highly recommend The Analyst to anyone who wishes to discover the underlying causes of their symptoms."
Dr. Alan Thal, MD - DrThal.com


Before you begin

   
You may leave the questionnaire at any point and return later to continue.


Basic patient information
    No information is EVER given to third parties.
    No personal data is stored on public web servers.
    You will receive NO additional spam by using this web site.

Name: *
Will appear on the report
(Can be a false name)
  
First *		   
Middle
Last *
Date of birth: *
MM-DD-YYYY (month-day-year) format.
Select questionnaire: *
Male or Female version		 Male
Female

Important!  The male and female questionnaires are very different.
E-mail address: *
Please check it VERY carefully
-- or else we can't contact you!
Later, you may specify a password so that others can not read your report.
* required


Report options
The report that you receive will be very detailed.  If you prefer to keep its size down, you may wish to select only those options below that are of interest to you.

Include?
 Conditions that you are already aware of
Would you like to read what we have to say about these?
 

 		 Treatment suggestions
Would you like your report to include a set of recommendations?

Note: Because of potential side-effects and interactions, The Analyst™ does not generally indicate treatment with pharmaceutical drugs.  However, it can suggest a comprehensive set of natural remedies and lifestyle changes, which we believe should always be tried first!
 

 		 Metabolic Typing
Would you like to see recommendations on diet and nutrition tailored specifically to you?
 

 		 Ayurvedic Typing
Would you like some basic recommendations based on this 4,000 year-old traditional Indian system?
 



Finally, we need permission to send you e-mails
I AGREE TO RECEIVE E-MAIL FROM DIAGNOSE-ME.COM

In line with anti-spam guidelines, we do not send unsolicited e-mails.  By checking this box, you agree to accept the e-mails that will result from the use of our system.  These include, but are not limited to, the following:
  • confirmation that we have received your questionnaire responses
  • notice of an incomplete questionnaire
  • your health analysis / report by The Analyst™.
We will not share your e-mail address with any third party.  You will not be added to any mailing list.  You can request at any time that we cease e-mail contact.



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