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Iridology Assessment Report Trial
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Iridology Assessment Report Trial
Iridology Assessment Report Trial
daprof
2019-05-22T17:38:16+00:00
Iridology Assessment Report Trial
Step
1
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10
- Client Information
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Clinic
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Email
Apply email address to where the results will be sent to.
Right Eye
Please upload right eye
Left Eye
Please upload left eye
Date
MM slash DD slash YYYY
Name
First
Last
This section is for the patient or client name.
Age
Main Complaint - Health History
The patient or client health history.
Health Genealogy Background
Does client know about any health issues with mother or father, grandmother or grandfather?
Right Eye
Please upload right eye
Left Eye
Please upload left eye
Constitutional Type & Subtypes
Lymphatic Constitution
Lymphatic Constitution
Pure Lymphatic Constitution
Neurogenic Sensitive or Neurolymphatic Constitution
Neurogenic Robust Constitution
Lymphatic - Hypoplastic Diathesis
Hydrogenoid - Hydrogenic Constitution
Hydrogenoid Rheumatic Diathesis
Classic Rheumatic Constitution
Rheumatic - Uric Acidic Diathesis - Mild
Rheumatic - Uric Acidic Diathesis - Moderate
Rheumatic - Uric Acidic Diathesis - Severe
Inclination
Predisposition
Homeopathic Constitutional Therapy
Haematogenic
Constitutional Types & Subtypes
Haematogenic
Haematogenic II
Inclination
Predisposition
Homeopathic Constitutional Therapy
Biliary Constitution
Constitutional Types & Subtypes
Classic Biliary Constitution
Ferrum Chromotosis
Rheumatic - Uric Acidic - Dyscratic Diathesis - Grade 1
Rheumatic - Uric Acidic - Dyscratic Diathesis - Grade 2
Rheumatic - Dyscratic - Hepatic Diathesis
Rheumatic - Uric Acidic - Dyscratic - Hepatic Diathesis
Rheumatic - Arthrotic Diathesis
Rheumatic - Arthrotic - Dyscratic Diathesis
Arthrotic - Dyscratic - Dysenzymatic Diathesis
Inclination
Predisposition
Homeopathic Constitutional Therapy
Pathological Constitutions
Constitutional Types & Subtypes
Glandular Pathological Constitution
Immuno Pathological Constitution
Cardio Pathological Diathesis
Vegetative-Spastic Pathological Constitution
Weak Connective Tissue \ Mesenchymal Pathological Constitution
Lipaemic Pathological Diathesis
Inclination
Predisposition
Homeopathic Constitutional Therapy
Constitutional Syndromes
Constitutional Types & Subtypes
Cardio Renal Syndrome
Cardio Abdominal Syndrome
Pancreatic Syndrome
Hepato-Gastric Syndrome
Inclination
Predisposition
Homeopathic Constitutional Therapy
Pre Cancerous Constitutions
Constitutional Types & Subtypes
Psoric
Sycotic
Carbon Nitrogen
Inclination
Predisposition
Homeopathic Constitutional Therapy
Conditions For Consideration
Right Eye
Please upload right eye
Left Eye
Please upload left eye
Anemia in Extremities
Anemia in Extremities
Not Indicated
Mild
Moderate
Heavy
Explanation
Herbs
Nutrition
Homeopathy
Body Acidity
Body Acidity
Not Indicated
Mild
Moderate
Heavy
Explanation
Herbs
Nutrition
Homeopathy
Catarrh/Mucous
Catarrh
Not Indicated
Mild
Moderate
Heavy
Explanation
Herbs
Nutrition
Homeopathy
Cerebral Anemia
Cerebral Anemia
Not Indicated
Mild
Moderate
Heavy
Explanation
Herbs
Nutrition
Homeopathy
Lymph Congestion
Lymph Congestion
Not Indicated
Mild
Moderate
Heavy
Explanation
Herbs
Nutrition
Homeopathy
Nerve-Stress rings
Nerve/Stress rings
Not Indicated
Mild
Moderate
Heavy
Explanation
Herbs
Nutrition
Homeopathy
Poor Assimilation
Poor Assimilation
Not Indicated
Mild
Moderate
Heavy
Herbs
Nutrition
Homeopathy
Radii Solaris
Radii Solaris
Not Indicated
Mild
Moderate
Heavy
Explanation
Herbs
Nutrition
Homeopathy
Sodium-Cholesterol
Sodium Cholesterol Ring
Not Indicated
Mild
Moderate
Heavy
Explanation
Herbs
Nutrition
Homeopathy
Underactive Skin
Underactive Skin
Not Indicated
Mild
Moderate
Heavy
Explanation
Herbs
Nutrition
Homeopathy
Venous Congestion
Venous Congestion
Not Indicated
Mild
Moderate
Heavy
Explanation
Herbs
Nutrition
Homeopathy
Right Eye
Please upload right eye
Left Eye
Please upload left eye
Elimination Organs to Consider
The Colon
The Colon
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
The Kidneys
The kidneys
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
The Lymphatic System
The Lymphatic System
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
The Lungs and Bronchials
Lungs and Bronchials
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
The Skin
The Skin
Not indictaed
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
Right Eye
Please upload right eye
Left Eye
Please upload left eye
General Organs and Glands
The Small Intestine
The Small Intestine
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
The Liver
The Liver
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
The Thymus
The Thymus
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
The Pituitary Gland
The Pituitary Gland
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
The Stomach
The Pineal Gland
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
The Pineal Gland
The Pineal Gland
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
The Heart
The Heart
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
The Spleen
The Spleen
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
The Bladder
The Bladder
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
The Gallbladder
The Gallbladder
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
The Thyroid
The Thyroid
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
The Pancreas
The Pancreas
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
The Spine
The Spine
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
The Prostate
The Prostate
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
The Uterus
The Uterus
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
Testes & Ovaries
Testes & Ovaries
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
The Adrenals
The Adrenals
Not indicated
Special care is indicated in this area
Explanation
Herbs
Nutrition
Minerals
Right Eye
Please upload right eye
Left Eye
Please upload left eye
The Collarette
Collarette Shape
Collarette Shape
Not indicated
Distended Collarette
Indented Collarette
Lateral Distention
Local Indentation
Ventral Distention
Frontal Indentation
Bilateral Distention
Zig-Zag Collarette
Partial Zig-Zag Collarette
Wavy Distention
Local Protuberance
Explanation
Collarette Shape - Additional Signs
Collarette Shape
Not indicated
Distended Collarette
Indented Collarette
Lateral Distention
Local Indentation
Ventral Distention
Frontal Indentation
Bilateral Distention
Zig-Zag Collarette
Partial Zig-Zag Collarette
Wavy Distention
Local Protuberance
Explanation
Collarette Shape - Additional Signs
Collarette Shape
Not indicated
Distended Collarette
Indented Collarette
Lateral Distention
Local Indentation
Ventral Distention
Frontal Indentation
Bilateral Distention
Zig-Zag Collarette
Partial Zig-Zag Collarette
Wavy Distention
Local Protuberance
Explanation
Collarette Structure
Collarette Structure
Not indicated
Hyperplastic
Hypoplastic
Parallel Track
Square-Shaped
Sectoral Absence
Funnel
Explanation
Collarette Structure - Additional Signs
Collarette Structure
Not indicated
Hyperplastic
Hypoplastic
Parallel Track
Square-Shaped
Sectoral Absence
Funnel
Explanation
Collarette Structure - Additional Signs
Collarette Structure
Not indicated
Hyperplastic
Hypoplastic
Parallel Track
Square-Shaped
Sectoral Absence
Funnel
Explanation
Right Eye
Please upload right eye
Left Eye
Please upload left eye
Iris Pigmentation
Indicated Pigmentation
Iris Pigmentation
Not indicated
Central Heterochromia
Sectoral Heterochromia
Yellow - Kidney
Orange/Pink/Yellow Pigments - Kidneys
Brown - Light, Medium, Dark, Red - liver
Fuscin Pigments - liver-gall bladder-pancreas
Pancreas Pigments
Rufin Pigments
Yellow/Orange Pigment
Black / Tar- Pre-Cancerous, also Liver
Black Hair Pigment
Explanation
Indicated Pigmentation - Additional Pigments
Iris Pigmentation
Not indicated
Central Heterochromia
Sectoral Heterochromia
Yellow - Kidney
Orange/Pink/Yellow Pigments - Kidneys
Brown - Light, Medium, Dark, Red - liver
Fuscin Pigments - liver-gall bladder-pancreas
Pancreas Pigments
Rufin Pigments
Yellow/Orange Pigment
Black / Tar- Pre-Cancerous, also Liver
Black Hair Pigment
Explanation
Indicated Pigmentation - Additional Pigments
Iris Pigmentation
Not indicated
Central Heterochromia
Sectoral Heterochromia
Yellow - Kidney
Orange/Pink/Yellow Pigments - Kidneys
Brown - Light, Medium, Dark, Red - liver
Fuscin Pigments - liver-gall bladder-pancreas
Pancreas Pigments
Rufin Pigments
Yellow/Orange Pigment
Black / Tar- Pre-Cancerous, also Liver
Black Hair Pigment
Explanation
Right Eye
Please upload right eye
Left Eye
Please upload left eye
The Pupils
Pupil Size
Pupil Size
Normal
Miosis
Mydriasis
Anisocoria
Explanation
Pupillary Deformations
Pupillary Deformations
Not indicated
Inferior Temporal flatness
Inferior Nasal Flatness
Superior Nasal Flatness
Superior Temporal Flatness
Medial Nasal Flatness
Lateral Temporal Flatness
Ventral Flatness
Frontal Diverging Ellipse
Explanation
Pupillary Deformations - Additional Signs
Pupillary Deformations
Not indicated
Inferior Temporal flatness
Inferior Nasal Flatness
Superior Nasal Flatness
Superior Temporal Flatness
Medial Nasal Flatness
Lateral Temporal Flatness
Ventral Flatness
Frontal Diverging Ellipse
Explanation
Pupillary Deformations - Additional Signs
Pupillary Deformations
Not indicated
Inferior Temporal flatness
Inferior Nasal Flatness
Superior Nasal Flatness
Superior Temporal Flatness
Medial Nasal Flatness
Lateral Temporal Flatness
Ventral Flatness
Frontal Diverging Ellipse
Explanation
Pupil Decentration and Multiformaties
Pupil Decentration and Multiformaties
Not indicated
Ventral Diverging Ellipse
Right Oblique Ellipse
Left Oblique Ellipse
Unilateral Ellipse
Unequal Pupil Diameters
Horizontal Ellipse
Verticle Ellipse
Rufin Pigments
Oval-Horizontal Form
Oval-Vertical Form
Oval-Diagonal Form
Frontal Diverging Ellipse
Explanation
Pupil Decentration and Multiformaties - Additional Signs
Pupil Decentration and Multiformaties
Not indicated
Ventral Diverging Ellipse
Right Oblique Ellipse
Left Oblique Ellipse
Unilateral Ellipse
Unequal Pupil Diameters
Horizontal Ellipse
Verticle Ellipse
Rufin Pigments
Oval-Horizontal Form
Oval-Vertical Form
Oval-Diagonal Form
Frontal Diverging Ellipse
Explanation
Pupil Decentration and Multiformaties - Additional Signs
Pupil Decentration and Multiformaties
Not indicated
Ventral Diverging Ellipse
Right Oblique Ellipse
Left Oblique Ellipse
Unilateral Ellipse
Unequal Pupil Diameters
Horizontal Ellipse
Verticle Ellipse
Rufin Pigments
Oval-Horizontal Form
Oval-Vertical Form
Oval-Diagonal Form
Frontal Diverging Ellipse
Explanation
Pupillary Margin
Pupillary Margin
Normal
Uniformly Thickened
Uniformly Granular
Aureole-Like
Non-Uniformly Thickened
Non-Uniformly Granular
Thin
Explanation
Right Eye
Please upload right eye
Left Eye
Please upload left eye
The Brain
Brain Indicators
The Brain
Not Indictatd
Animation and Life
Sensory Locomotion Area
5 Sense Area
Equilibrium - Dizziness Center
Sex Impulse
Ego Pressure
Medulla
Inherent Mental
Mental Abilty
Aquired Mental Speech
Explanation
Normal function
Abnormal function
Attributes
Recommendations
Brain - Additional Indicators
The Brain
Not Indictatd
Animation and Life
Sensory Locomotion Area
5 Sense Area
Equilibrium - Dizziness Center
Sex Impulse
Ego Pressure
Medulla
Inherent Mental
Mental Abilty
Aquired Mental Speech
Explanation
Normal function
Abnormal function
Attributes
Recommendations
Brain - Additional Indicators
The Brain
Not Indictatd
Animation and Life
Sensory Locomotion Area
5 Sense Area
Equilibrium - Dizziness Center
Sex Impulse
Ego Pressure
Medulla
Inherent Mental
Mental Abilty
Aquired Mental Speech
Explanation
Normal function
Abnormal function
Attributes
Recommendations
Iris Density
Iris Density
Iris Density
1st Degree
2nd Degree
3rd Degree
4th Degree
5th Degree
6th Degree
Explanation
Nutritional
Additional Notes
Additional Recommendations
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