ZHANG CLINIC LYME DISEASE
TREATMENT SURVEY
Please enter
your age
Male
Female
1) How long have you been on
the current protocol?
1-2
months
3-4
months
5-6
months
More
than 6 months
2) Are you taking Allicin (garlic capsules) now?
Yes
No
Don’t
know3)
If you are NOT taking Allicin, which other herbs are you taking?
(You may choose more than one)
Coptis
HH
R5081
4) Are you taking Artemisea now?
Yes
No
Don’t
know
5)
Have you experienced any Herxeimer’s reaction?
Yes
No
Don’t
know
6) Those who experienced Herxeimer’s reaction, when did it start?
Between
1st to 2nd week of the protocol
Between
3rd week to 1st month of the protocol
In
the 2nd month of the protocol
In
the 3rd month of the protocol
Did
not experience Herxeimer’s reaction
7) If you did experience the Herxeimer’s reaction, how long did it
last?
A
few days
1
week to 2 weeks
More
than 2 weeks
Comes
and goes periodically
8) How severe was Herxeimer’s reaction?
Mild,
symptoms are sometimes noticeable
Moderate,
symptoms are constantly noticeable, but manageable
Severe,
barely manageable
Very
severe, could not conduct daily life
9)
Are you taking the AI#3 formula?
Yes
No
Don’t
know
10) If you are taking the AI#3 formula, do you think it is helping
to control the Herxeimer's reaction?
Yes
No
Don’t
know
11) Are you taking the Circulation P formula?
Yes
No
Don’t
know
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