Heshoutang Personalized Assessment

Let's Start With You

Your answers help us understand your overall health picture before we look more closely at your symptoms and patterns.

Step 1 of 10 10%

Personal

Concern

Spleen & Stomach

Lung & Skin

Kidneys

Liver

Heart

Other Signs

Health Story

Review

About You

Tell us a little about yourself so we can create your Heshoutang patient profile.

STEP 1 · ABOUT YOU

Before symptoms, we begin with the person.

This first step creates the basic patient profile that everything else will connect to. Start with who you are, then we’ll move into contact, location, and a few health measurements.

Personal Information

Basic information about you.

First Name *

Last Name *

Date of Birth *

Sex *

Marital Status

Number of Children

Occupation

Preferred Communication Language

HOW WE REACH YOU

Next, give us the best way to stay connected.

Email and phone are used for your patient profile and follow-up communication related to this assessment.

Contact Information

We will use this information for your patient profile and follow-up communication.

Email Address *

Phone Number *

WHERE YOU ARE

Your location helps the system know where care should go next.

Location information can later help Heshoutang route your assessment to the appropriate location or member and support appointment planning.

Your Location

Your location can later help us connect you with the appropriate Heshoutang location or member.

Street Address

City *

State / Province *

ZIP / Postal Code *

Country *

How Did You Hear About Us?

OPTIONAL · BASELINE

Finish with a few measurements — only if you know them.

These numbers give us a useful baseline, but they are optional. Leave anything blank if you do not know it.

Basic Health Information

If you know these measurements, please enter them below.

Height

Weight

Pulse

Blood Pressure (if known)

/ mmHg

Blood Sugar (if known)

Your progress is saved as you continue.

Product

Let's Start With You

About You

Before symptoms, we begin with the person.

Personal Information

Next, give us the best way to stay connected.

Contact Information

Your location helps the system know where care should go next.

Your Location

Finish with a few measurements — only if you know them.

Basic Health Information

Tell Us What’s Bringing You Here

Your Main Concern

Start with what brought you here today.

Main Concern

If your concern can be seen, you may show us.

If available, add a front and back photo of your tongue.

Now narrow the picture to the symptoms that matter most.

Symptoms That Matter Most

Next, connect your experience with any diagnosis or care you already have.

Existing Diagnosis & Current Care

Finish with the change you actually want.

Your Goal

Digestive Health

Spleen & Stomach

Start with appetite — how the body asks for food.

Appetite & Eating

Now look at what happens after food reaches the stomach.

Stomach Comfort

The digestive story can also show up before the stomach.

Nausea and vomiting deserve their own moment.

Anything we did not ask?

Respiratory & Skin

Lungs & Skin

Begin with the way breathing feels.

Cough & Breathing

Now follow the respiratory pathway upward.

Breathing is not the whole story.

Finish by looking at the skin.

Kidneys & Bladder

Kidneys & Bladder

Start with where the body is speaking.

Pain

Now move from pain to hearing.

Next, describe what urination is actually like.

Urination Frequency

Urine Color

The Kidney system story also includes bowel movements.

If this section applies to you, tell us about male sexual and reproductive health.

Liver & Gallbladder

Liver & Gallbladder

Start with the rib area, then follow the pattern inward.

Rib Area & Emotion

Next, look at two quieter signs.

Now move upward to the head and eyes.

Finish with dizziness.

If this section applies to you, tell us about your menstrual pattern.

If applicable, add a few details about sex desire, fertility, and ovulation.

Heart & Small Intestine

Heart & Small Intestine

Start with how the heart feels in everyday life.

Heartbeat & Chest

Next, move from the heart into sleep.

Finish with one important history question.

Other Body Signs

Other Body Signs

Now look at a few signs that do not belong to only one system.

Stones & Hair

Joints & Face Color

Now move to body temperature and edema.

Ulcer

Your Health Story

Your Health Story

A short story can connect the details.

Other Problems

Now add the context around daily life and history.

Daily Habits

Review & Submit

Review Before You Submit

Your assessment has been saved.