Comprehensive symptom quiz

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Hi there! What's your first name?* This field is required.
2
How old are you? * This field is required.
3
What's your gender?* This field is required.
Female
Male
4
Are you here for help with fertility?
YESNO
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What brings you here today?* This field is required.
I'm feeling sick and need a doctor
I'm looking for immune system support
I'm looking for help with fertility
I have a number of symptoms and want to take your quiz (this quiz focuses on hormones, adrenals, thyroid, and gut issues)
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What symptoms are you experiencing?* This field is required.Check all that apply
Cough
Fever
Shortness of breath
None of these
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What symptoms are you experiencing?Check all that apply
Runny nose
Body aches
Sore throat
UTI symptoms
Headache or head congestion
Pain
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We are now offering an Immune Support Program to help you stay healthy.

To learn more about the program please click here. If this is not what you were looking for, please hit "PREVIOUS" below and make a different selection.
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One or more symptoms that may be associated with COVID-19 and we are not the right choice for you at this time.

We recommend you go through a formal screening process for testing by one of your local hospitals, clinics, or health systems. If you are in the Milwaukee area, below are local contancts:

Ascension:

Individuals who wish to be tested must first be pre-screened by an Ascension Medical Group provider, by phone (1-833-981-0711), or virtually using Ascension Online Care (ascension.org/OnlineCare).

Advocate Aurora Health:

Testing requires authorization. Use our COVID-19 Symptom Checker or call 866-443-2584 if you think you’ve been exposed to COVID-19 or are experiencing symptoms. Starting with our symptom checker will quickly guide you on what to do next.

Froedtert and The Medical College of WI:

If you think you've been exposed to COVID-19, are experiencing symptoms or need to learn more about testing, call our hotline at 414-805-2000.

ProHealth Care:

Call ProHealth's Coronavirus Hotline at 262-928-4499
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Please tell us how often or how severely you experience the following symptoms
11
Not sleeping well (trouble falling or staying asleep)
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
12
Moody or irritable
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
13
Decreased libido and sex drive
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
14
Anxious
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
15
Foggy brain, thinking, or memory
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
16
Dry eyes, hair, or dry skin
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
17
Fatigued, sluggish, or constantly tired
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
18
Thinning head hair
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
19
Palpitations (skipped heart beats or heart pounding)
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
20
Hot flashes or night sweats
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
21
Vaginal dryness and painful sex
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
22
Excess body hair on face, chest, or arms
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
23
Irregular menstrual cycles, heavy or painful periods
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
24
Sexual performance is not as good as it used to be
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
25
Decrease in strength and endurance
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
26
Feeling less social
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
27
Must have caffeine or sugar to get or keep going
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
28
Catch more colds or takes longer to recover from illness
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
29
Feeling overwhelmed
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
30
Feeling tired and anxious (“tired and wired”)
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
31
Losing hair on eye brows or eyelashes
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
32
Thin and brittle fingernails
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
33
Cold hands and feet or feeling colder than everyone else
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
34
Constipation
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
35
Change in bowel movements (constipation or diarrhea)
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
36
Abdominal bloating, uncomfortable gas, indigestion, or heartburn
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
37
Certain foods cause abdominal discomfort or diarrhea
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
38
Have eczema or chronic skin rashes or itching
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
39
Have a diagnosed autoimmune condition
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
40
Unexplained weight gain, or difficulty losing weight
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
41
Have you tried to become pregnant in the last 6 months unsuccessfully?
YESNO
42
Do you have a history of at least one miscarriage?
YESNO
43
Are you currently under the care of a fertility specialist (reproductive endocrinologist) and would like to enhance your chances of getting pregnant?
YESNO
44
Are you hoping to conceive naturally, without medications or procedures?
YESNO
45
Do you have a difficult time going to or staying asleep?
YESNO
46
Are you under a lot of stress?
YESNO
47
Have you noticed your hair thinning?
YESNO
48
Do you have irregular periods?
YESNO
49
Do you have very heavy periods?
YESNO
50
Do you have bothersome stomach symptoms like indigestion, heartburn, bloating, diarrhea, or constipation?
YESNO
51
How frequently do you feel exhausted?
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
52
Have you gained weight around your belly?
Not a problem or never true
Minor or seldom true
Mild or sometimes true
Moderate or often true
Severe or very frequent
53
If you found a doctor who can help you with your symptoms, how soon would you want to see them?
As soon as possible
This week
This month
Not sure
54
How many clinicians (doctors, specialists, alternative medicine practitioners, etc.) have you seen for these symptoms?
1-2 different clinicians
3-5 different clinicians
6-9 different clinicians
over 10 different clinicians
55
How familiar are you with holistic and functional medicine?
Not at all
I know a little bit
I've done my research & know enough
I've been using it for a while
I'm an expert
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What's your email* This field is required.We need your email so we can send you the results and other useful information
example@example.com
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What state do you live in?* This field is required.Your state will help us show you available clinicians in your area
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
58
Would you like someone on our team to call you and help figure out if we are the right solution for you?* This field is required.We are not telemarketers and will only call about this topic.
YESNO
59
What's your phone number
Area Code
Phone Number
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Your Hormone Balance Score (anything over 37 may indicate Hormonal Imbalance)
61
Your Adrenal Health Score (anything over 20 may indicate Adrenal Fatigue)
62
Your Thyroid Function Score (anything over 28 may indicate a Thyroid Disorder)
63
Your Gut Function Score (anything over 24 may indicate a gut imbalance)
64
By clicking submit, you agree for Vytal Health to store and process your information to provide you with the content requested.* This field is required.You are subscribing to updates regarding this request plus other health opportunities. You may unsubscribe from these communications at any time, check out our Privacy Policy.
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Please verify that you are human* This field is required.
66
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We are now offering an Immune Support Program to help you stay healthy.

One or more symptoms that may be associated with COVID-19 and we are not the right choice for you at this time.

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