TB-Miasm Personal Assessment Form

Completing this form will give you a sense of how well you and your nervous system tolerate having TB-Miasm, a main cause of ADD/ADHD. Since 60% to70% of the population has this inherited TB-Miasm bug in their system, there is a good chance you also have it to some degree. If you have been labeled as having ADD/ADHD, a very large part of your problem is being caused by having Tuberculosis somewhere in your family’s history, and you will definitely be challenged by having TB-Miasm.

After you complete this form, look to see if you have written down more than just a few 3’s and 4’s. If so, chances are you have TB-Miasm and it is causing you a tremendous loss of productivity in most areas of your life. Many people would not consider themselves to have ADD but on closer examination realize that they have had a lifetime of reading difficulty, and especially remembering what they read. That’s a sure example of someone with TB-Miasm. Note; there is a simple, full proof test for determining if you have TB-Miasm, and it only takes a minute or so to complete.

Indicate using; 1, 2, 3, or 4 in front of each of the following emotions/operating states that you currently experience.

1. = experience rarely

2. = experience sometimes

3. = experience often

4. = experience most of time

____ feeling frazzled ____ hard to focus

____ not confident ____ sense of isolation

____ frustration ____ lose things easily

____ anxiety ____ late for meetings etc.

____ overwhelm ____ easily distracted

____ not feeling capable ____ lack of impulse control

____ anger ____ not feeling prepared

____ low self worth ____ being disorganized

____ depressed ____ out of control

____ being unsettled ____ feelings of inadequacy

____ hard to concentrate ____ feeling the need to fit in

____ forgetful ____ argumentative

____ procrastination ____ feeling incomplete

____ sadness ____ not being prepared

____ edgy & unsettled ____ hard to sit in one place

____ feeling hostility ____ being unhappy