Health Assessment – Ancient root

Share your health concerns and daily experiences so Dr. Zhu can personally review your information and prepare your personalized wellness report.

Before you begin

Have your Ancient Root order number ready. You can find it in your order confirmation email.
Use the same email address you used at checkout so we can match this submission to your order.
For the health questions below, think about how you have generally felt over the past year and choose the answer that best describes you.
Prepare two clear tongue photos. Both the front and underside photos are required.

How to photograph your tongue

Use natural daylight, keep the camera steady, and avoid filters. Follow the two examples below.

Example showing the front of the tongue extended naturally — **Photo 1: Front of tongue**
Extend your tongue naturally. Keep its surface and coating in focus.

Example showing the underside of the tongue lifted upward — **Photo 2: Under the tongue**
Lift your tongue upward so the underside is clearly visible.

Your questionnaire

This form uses Hulk Contact Form Builder to process your answers and uploaded photos. Please read our Privacy Policy and the consent statement before submitting.

Open questionnaire in a new tab.

After you submit

Dr. Zhu will personally review your answers and photos and prepare your personalized wellness report within 24 hours once payment is confirmed and your questionnaire and both photos are complete and clear.