Questionnaire

 

We strongly encourage you to read the following articles to get an understanding of the homeopathic approach before you fill and submit this questionnaire.

 

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Present Problems
Please describe your present problems, when they started, how and when they become aggravated etc...

State of mind
Please write about your mental state (example: your feelings)

General Information
Please write about your appetite, thirst, cravings, aversions, flatulence, sleep, dreams, sweating, etc...





DISCLAIMER: The information provided is for educational purposes only. It is not meant to diagnose or treat any health condition and is not a replacement for treatment by a healthcare provider.