Questionnaires

To help me more accurately prescribe a suitable homeopathic treatment, please select the appropriate questionnaire (or the one I have asked you to) and email it back to me before the consultation. In the general questionnaires, there are three different formats to allow for different computer systems. If you can’t attach it to an email, please copy and paste it in the contents of the email.

If you use the .pdf, then you may have to print them out, fill them in, then scan them to attach to an email. You may also be able to edit them using Adobe Acrobat. If these measures don’t work, please just list those areas that are relevant to you, in an email. Please don’t photograph them on your phone and send these. They are very difficult to read.

Please take your time and be as accurate and honest as you can.

THE GENERAL QUESTIONNAIRES

Adolescent questionnaire.pdf

Adolescent questionnaire.docx

Adolescent questionnaire.txt

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Adult questionnaire pdf

Adult questionnaire docx

Adult questionnaire txt

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Child questionnaire.pdf

Child questionnaire docx

Child questionnaire txt

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Cat or Dog questionnaire pdf

Cat or Dog questionnaire docx

Cat or Dog questionnaire txt


THE PARTICULAR QUESTIONNAIRES – For Chronic conditions

The questions in these questionnaires relate only to particular area affected (rather than your general symptoms), unless otherwise stated.

Additional Complaints

Background

Cardiovascular

Ear, Nose, Throat

Gastrointestinal Tract

Gynaecolgical

Mind

Musculoskeletal System

Neurology

Perception, (including ADD, ADHD)

Respiration, Airways

Sleep Disturbances

Urinary Tract


THE PARTICULAR QUESTIONNAIRES – For Acute conditions

Ear, Nose and Throat

Gastrointestinal Tract

Headache and Vertigo

Infants and Small Children

Influenza and Influenza-Like Disease

Muscularskeletal Disease

Respiratory Problems

Urinary Tract