Background : Guibi-tang is one of the most common herbs in oriental medicine. Principally, this medicine heals illness from overstress. Therefore, it is frequently used in the ancient community. Because of insufficiency in data, objective judgements are difficult in remedial effects by Guibi-tang. In order to make objectivity diagnose data, this research is developed. Purpose : The aim of the research is to make questionnaire for the medicine and the objective is to sell to the public from the local clinic. Methods : The questionnaire which includes symptoms and signs for diagnose of Guibi-tang is studied by the Delphi method and average value. Results : By the Delphi method and average value, 22 Items of questionnaires are choosen for the research. Conclusions : Further research is necessary for modification of questionnaire by statistics and cerification by clinical trial. The statistics and verification by clinical trial is necessary with modification for further research.