Progress Submission Form

DigestaCure Users: Submit monthly or bi-monthly and contact support when you need assistance.

Name * First Last
Phone * - ### - ### ####
Email *

We do not share your email address, and will only use it to reply to you about your progress submission.
My Age:
My Height:
My Weight:
How much sleep are you getting on average nightly? *
How many bowel movements you are having on average, daily? *
How many ounces of water are you drinking daily? *
My illness or disease: *
My symptoms prior to taking DigestaCure:
abdominal cramping abdominal pain abdominal swelling abdominal tenderness abnormal growths abnormal tissue formation abscess acid reflux agitation allergies anemia bacterial infection bloating blood in stools burning pain confusion constipation depression diarrhea digestive problems drowsiness fainting fatigue fistula flatulence fungal infections excess gas gland or lymph problems hair loss headache hemorrhoids high blood pressure high blood sugar levels high cholesterol hormonal imbalances immune problems indigestion Infections inflammation (general) insomnia intestinal bleeding intestinal obstruction Irritability joint inflammation joint pain loss of muscle tone low blood sugar levels memory loss menstrual problems migraine nasal inflammation nausea parasitic infections polyps rectal bleeding skin disorders tissue degeneration ulcers vision loss yeast infections
Check all that apply and write in all others not shown.
List any other symptoms or conditions not shown:
I have been in the healing process for:
Months *
Weeks *
Days *
How many AUTOIMMUNE-X capsules are you currently taking per day? *
How many scoops of AUTOIMMUNE-X POWDER are you taking per day? *
How many scoops of AceMannan M.D. POWDER are you taking per day? *
How many scoops of APMC-M.D. Neurological POWDER are you taking per day? *
How many Stem-Cell Excell Capsules are you currently taking per day? *
Are you currently using the AceMannaDerm topical cream? *
My symptoms that which have gone away are: *
My symptoms which have improved are: *
At this time, I would estimate that my overall condition has improved: (check one) *

At this time, I would estimate that my overall condition has improved: (check one) 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
My current most bothersome symptoms are:
I will call to speak to a specialist. 1-888-671-2873

Progress Submission Form

Progress Submission Form

I have been in the healing process for: