Symptoms Evaluation Assessment | Integrated Health Foundation

Do You Ever Experience Any of the Following?

• Neuropathy

• Numbness or tingling

• Issues with circulation

• Intense brain fog

• Chronic pain or fatigue

• Insomnia

• Random spikes in your heart rate

• Inconsistent blood pressure

• Low energy

• Chest pain

• Shortness of breath

• Histamine issues

• Poor sleep or intense dreams

If you’ve seen multiple doctors, tried different treatments, and still don’t feel like yourself — you’re not alone.

Studies show that many chronic symptoms are connected to imbalances in the autonomic nervous system, a missing piece rarely discussed in traditional medicine.

Take our 2-minute assessment and get insights that could change everything.

Check the disclaimer box and then Click 'next' below to start the assessment 👇

Disclaimer: This assessment is for educational purposes only and does not provide a medical diagnosis. By proceeding, you consent to share your responses with The Integrated Health Foundation for confidential analysis of autonomic symptom patterns.

Have you received a diagnosis? *

Yes

No

If you did receive a diagnosis, by whom was it made?

A local specialist (cardiologist, neurologist etc)

An autonomic specialist

A primary care doctor

Someone at the hospital

Select all that apply.

When did you receive the diagnosis? *

If you have not received a diagnosis, type 'none'.

Please list any other conditions that you have received a diagnosis for: *

If you have not received any other diagnosis, type 'none'.

What is your date of birth?

Was there a specific event or period in your life when you first began to notice symptoms? *

Tell us if there was a time you started to notice your symptoms first develop, or if you can remember a particular event in your life when things started to change for you.

How often do you experience these symptoms? *

Everyday

From time to time

I have random major crashes

It’s hard to say

Ever since you started experiencing symptoms, have you had trouble with exercising? *

Exercising is very difficult for me

Walking is difficult for me

I find it hard to get up a flight of stairs

Whenever I try I get very short on breath

I can’t exercise like I used to

I’m too tired to try exercising

I have a severe crash and my symptoms get much worse after exercise

No issues with exercise

Select all that apply.

Have you recently experienced any issues with temperature? *

I find it hard to stay warm when it’s cold

I find it hard to stay cooler when it’s hot

I often feel faint when it’s warmer

I feel pins and needles in my hands or feet especially in the cold

I have other symptoms when it’s cold (please type)

No

Select all that apply.

What other symptoms do you have when it's cold?

How often do you experience these issues? *

Everyday

From time to time

I have random major crashes

It’s hard to say

Have you recently had any difficulty with any of the following activities? *

Doing basic household chores

Attending work or school

Being able to sleep at night

No

Select all that apply.

Have you recently been admitted to hospital? *

Yes

No

Are there any other symptoms you’re experiencing, or anything else you’d like to share with us at this time? *

What is your biological sex *

Male

Female

Rather not say

What is your first name? *

What is your last name? *

What is your phone number? *

Please share the email you would like us to send your evaluation results to? *

We will use this email to send you a report with your results.