Homeopathy for Life

What brings you to me?

What is the main condition requiring treatment?

Aetiology – when did it start, how did it start?

Concomitant – what else happens along with the disease?

Amelioration/aggravation – anything that makes it feel better or worse?

All details about the disease which you feel are important and relevant from your viewpoint e.g. how does the pain feel – aching, throbbing, cutting etc.  Frequency of episodes.

 

Your previous medical history

History of any illnesses in the past e.g. jaundice, typhoid, severe viral infections, recurrent illnesses like malaria.

Childhood illnesses like measles, mumps, chicken pox.  Vaccination history.

Any operations or bad injuries.

Any sexually transmitted diseases.

For ladies, patterns of menstruation which may give concern, heavy bleeding, clots, start of menarche.  Any miscarriages, stillbirths or problems during pregnancy such as diabetes during pregnancy.

Any known or suspected allergies e.g. milk, wheat, peanut etc.

Any medication, vitamins or mineral etc. supplements.

Have you had any dental work done recently or in the past? Please give any detail you can, it is important.

 

Daily habit patterns

Details about diet if possible, any favourite foods, fluid intake during the day given as water and other fluids separately.

Is food eaten on time, what is your appetite like? Do certain foods make you feel better or worse?  Do you feel drowsy after food or nauseous etc. details.

What is your digestion like?  Do you suffer from bloating, discomfort, nausea before or after meals or drinks?  How often do you need to void your bowels and pass urine?  Anything of concern in the frequency or type of motions or urine passed?

Please give any relevant information about your sleep patterns.  The amount of sleep required and if that is being met, the quality of sleep – are you a light sleeper or a sound sleeper.

Dreams – any dreams which have occurred repeatedly, any striking nightmares, dreams of death or dead people, all of these are very important to the remedy prescribing.

 

Family medical history

Details of any major illnesses which your parents or grandparents from both sides may suffer e.g. diabetes, high blood pressure, cancer etc.

Are there any illnesses which your siblings suffer from, maybe more than one sibling? Please give details.

Use your own words to give some idea about the type of person you are.  How do people who know you describe you, family, and friends.  What makes you happy, sad?  What makes you worry the most, whom do you rely on in times of stress and worry?

 

Social History

Please give some information about your work and how you feel about it.

Give details on your marital state and how you view it in relation to life.

Any worries, stress or anxiety about your work, family, and children please state.

 

Please remember, I can only help you based on the information that you give me – the more complete and accurate the details the more efficient the treatment.  Any symptom that affects you strongly, or you believe to be of great concern is important to the case.  The information you give is highly confidential and relevant to the prescribing of your remedy, as homeopathy is a thoroughly individual form of medicine.  You are unique as a person and so is your remedy, your treatment and your response to it.  Any further questions you may have please feel free to enquire as it will only help in your treatment.  Thank you.

 

You may cut, copy, paste this questionnaire into your message window and add your replies to the queries and email it back to me.