Mail Order: Three Treasures Wellness Consultation

Tongue Diagnosis

In Traditional Chinese Medicine, the tongue shows what’s happening inside the body. Practitioners look at its color, shape, and coating because different parts of the tongue connect to different organs. Changes in the tongue can reveal imbalances, helping the practitioner decide on the best treatment.
Take a picture of your tongue in good light, making sure as much of your tongue as possible is visible. You can use the 'Take Photo' option to capture a new picture or upload an existing photo from your device.
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URINARY FUNCTION, PERSPIRATION, SALIVA
How often do you need to urinate each day?
How often do you need to urinate each night?
Do you experience any discomfort when urinating?

YesNo
If yes, please describe:
Do urinary issues disturb your sleep?

YesNo
How many glasses of water, tea and/or beverages do you consume each day?
Do you perspire easily?

YesNo
Under what conditions do you perspire?
Do you experience frequent dry mouth?

YesNo
Please share any additional details about your urinary function, perspiration, or saliva that you feel are relevant and were not covered in this questionnaire.

BIORHYTHMS

Biorhythms are your body’s natural cycles, like the daily rhythm that regulates your sleep, energy, and digestion. In TCM, we look at these patterns to understand if certain times of day consistently bring up symptoms or changes. This helps us identify potential imbalances and better support your body’s natural flow of energy.
Do you notice any recurring health-related symptoms or changes, good or bad, that tend to happen at certain times of day?

YesNo
If yes, please describe:
What is your preferred time to wake up?
What is your preferred time to go to sleep?
Do you take a regular nap?

YesNo
If yes, when?
What time do you eat your first meal?
What time do you eat your last meal?

INFLAMMATORY STATUS
Do you experience swelling in any part of your body?

YesNo
If yes, please specify the area(s):
Do you often feel stiffness or pain in your joints, especially in the morning or after periods of rest?

YesNo
Do you experience frequent redness, warmth, or tenderness in specific areas of your body?

YesNo
Have you been diagnosed with any chronic inflammatory conditions (e.g.,arthritis, IBS, eczema)?

YesNo
If yes, please specify:
Please share any additional details about inflammation that are relevant and were not covered in this questionnaire.

TOXICITY
Have you been exposed to any environmental toxins or chemicals (such as pollution, pesticides, heavy metals) that may affect your health?

No, I have not been exposed to any known toxinsYes, occasionally exposed to toxins (e.g., pollution, household chemicals)Yes, frequently exposed to toxins (e.g., occupational exposure, contaminated areas)Not sure

CHRONIC PAIN
Do you experience any chronic pain?

YesNo
If yes, what's the frequency?
If yes, what are the location(s)?
How would you describe the severity of your chronic pain?

Mild: It’s present but doesn’t interfere with daily activitiesModerate: It affects some activities but is manageable.Severe: It significantly impacts daily activities and quality of life.Unbearable: It is constant and overwhelming, severely limiting my ability to function.
Are your pains sharp or dull?

SharpDull
Please share any additional details about chronic pain that are relevant and were not covered in this questionnaire.

MEN
Do you have any known prostate issues?

YesNo
Do you experience any issues with sexual functioning, including libido or erectile dysfunction?

No concernsOccasional difficulties (e.g., with libido or erectile dysfunction)Frequent difficulties (e.g., with libido or erectile dysfunction)Prefer not to answer
Do you have any known fertility issues?

YesNo
If yes, please describe:
Please share any additional details about your reproductive or overall men’s health that are relevant and were not covered in this questionnaire.

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Three Treasures Wellness Consultation