Language
  • English (UK)
  • Two Legs and Four Holistic Health - Adult Questionnaire

  • In order to make an accurate prewscription, I depend on your co-operation. Homeopathic treatment is mainly based on the symptoms you provide me. If I am to make a successful prescription, I must know all the details of your problems. I must also understand you as an individual, including your reactions to stress, your past, your family history, your nature and your mental make up.

    The information you provide enables me to restore your health.

    In order to achieve this, I shall be asking you many questions. Each one has great significance to me, even those you may consider irrelevant to your health issue. This is why you need to be frank and free with all the relevant information.

    Please read each question carefully. Don't keep anything back. If necessary, ask someone close to you for more information. 

    Everything you tell me is in complete confidence. This questionnaire is not obligatory.

    This is a lengthy questionnaire, so be prepared to take time to fill it out.

    You can save the document to complete later. Make sure you click on 'Submit' at the end.

    You can fill out as much or as little as you desire. However, the more info I have the better able I can help. Health is complicated and many factors contribute to ill health. Homeopathy examine every possibility.

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  • Your Health Concerns

  • Your Digestion

  • Your Body

  • Your Sleep

  • Your Sexuality, Hormones

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  • Your Nature, Mind

  • Your Past

    Every disease, poisoning, drug or injury leaves its mark and remains a weak point in the system, affecting us more than we may realise. Homeopathic treatment takes these details into consideration. Please give as much detail as you can.
  • Thank you!

    CONGRATULATIONS in completing this marathon questionnaire! This is a significant step in your journey to wellness.
  • Re-scheduling or Cancellations

    Homeopathic consultations take time. My appointments are lengthy to discover the core reason for your ill health. So cancellations or failure to make an appointment makes a big impact on my day. Inevitably there are times where you need to re-schedule your appointment. Wherever it is possible, I do appreciate you giving me as much notice as possible, at least 24 hours is preferred. Often, people ring me early in the day for an appointment and it is frustrating for us both when there is apparently no free slot, which ultimately becomes available.Those who fail to attend to a prearranged appointment or don’t give me 24 hour advance notice may be charged for the full consultation. I appreciate your consideration.
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