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How to Use the Questionnaire
Answer the Questionnaire:
Supply all of your personal and presenting problem information.
Answer ALL questions, including those for female or male, whichever applies.
Your answers should be relevant to your symptoms at the present time except for the appropriate questions dealing with past history, or specific time periods, example: past 3 months.
If you need to make a comment about a particular question, there is a comment box at the end of each section. Include the question number in the comments section and write your comment.
Include any other information or medical diagnoses that you feel would be pertinent to your symptoms on the Comments page.
Print and use the female/male body pictures to mark or shade in the problematic areas you are experiencing. Be sure to describe these as you mark them. Use a colored or blue pencil or pen. You will find these body drawings under the appropriate section for male or female.
Follow the directions below completely.
Build up saliva in your mouth on the tongue.
You need to use Q-Tips with paper stems NOT plastic stems. Wet each side of the Q-Tip with saliva.
Place both Q-Tips in a blank envelope that does not have security ink inside.
Place this envelope in another envelope and seal it. (You should be the only one handling this.)
Write your name & date on the envelope.
Sending the Information to Us
Place the saliva sample envelopes inside an envelope that is addressed to us along with:
A copy of the body drawing indicating your problem areas.
Your remittance for $75.00 made payable to Natural Healing (if you are sending a check which you will indicate on the "Personal Information" page).
Note: If you are a member, your first evaluation is at no cost. Therefore, you will not need to send any money for the evaluation. New members will send the membership fee. If this is your second evaluation as a member, you should send 1/2 of the evaluation cost.
Place your name and a stamp on the envelope and put it in the mail to: Dr. Larry Tillman NMD, 4801 Albright Road, Clarksville, TN 37043. (931-358-2277)
We will complete the results of the evaluation in a report which will contain our recommendations including:
Findings of your imbalances
Homeopathic/Herbal remedy recommendations
A statement of remedy costs
We will complete the results of the evaluation in a report which will be mailed to you.
You will be asked to look over the report and call Dr. Tillman for a consultation about the report.
At that point, you would order the recommended remedies to begin your program.
Back to About Our HealthChek 2000 Questionnaire