Clients
The following link allows you to print off our forms in the comfort of your home or office, fill them out as time allows and bring them to your first appointment. Please take a moment and read "About Your Homeopathic Consultation" below, so you are familiar with the process.
Pre-Consultation Forms
for New Patients - 4
pages
{click
here}
This document includes:
Pages 1 through 3: Pre-consultation and Medical History Questionnaire
Page 4: Waiver and Fee Schedule
About Your Homeopathic Consultation
The interview process for a homeopathic consultation is quite unique. As a homeopath, I will be treating you wholistically, meaning that I will be taking into consideration your entire body, mind, and spirit when I choose the most appropriate remedy for you. Below are some “tips” and some examples that might help to prepare you for this experience. It may seem like a lot of information, but I will be acting as your guide through the interview itself, and together we will cover all the bases so that you can begin the process of healing.
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Always describe the beginning of your complaints. State just how they began and refer to any changes that may have taken place since.
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Mention all previous illnesses. A complete history of your health in important, even of such things as skin diseases, warts, fevers, and sores. Tell the location of these illnesses or injuries as well as what treatment was used.
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Describe all mental thoughts such as likes and dislikes, desires, fears, hurried feelings, anxiety, lack of interest, discontent, irritability, absentmindedness, et cetera. Describe things that annoy you such as opinionated people, loud music, or being touched. Tell how you are affected by the weather and seasons, exercising or eating certain foods, and by sleep. Discuss any emotional shocks, frights, disappointments, etc., of the past or the present that have affected you in a significant way.
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Discuss your food cravings or aversions. Tell about your thirst. Is there any food or drink that you “just have to have?”
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Describe any pains with reference to their location, whether or not they extend to other parts, or whether they come on suddenly or slowly. What does the pain feel like? Use analogies as much as possible, for example, “the pain feels like a nail being driven into my head.”
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Are there things that make you feel better or worse? Some examples might be movement, resting, heat, or cold. What relieves your pain?
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Try to describe any sensations in your body using analogies. For example, “I feel as if an icy finger is being dragged between my shoulder blades.”
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Describe your discharges – are they thin, copious, thick, green or yellow? Do you have abnormal bleeding of any kind? Is your urine red or clear? Do you have pain before, during, or after urination or defecation? Are your stools complete or shaped like little balls? Do you have to strain to expel feces? Do you have chronic constipation or diarrhea?
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Women should discuss their menstrual periods. When did it first begin? Are your periods regular, painful, heavy, or sporadic? How do you feel around your period? Have you ever been pregnant? Any history of miscarriage or pelvic surgery? Has your sexual desire changed in any way?
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Men should discuss any changes in their sexual desire. Is there any blood in the semen? Do you have any difficulties achieving or maintaining erections?
- In general, are you a hot or cold person? What
position do you sleep in? Do you snore, grind your teeth, or
walk in your sleep? Do you like to nap and do you feel
better or worse afterwards? Do you have any recurring dreams
or do your dreams ever come true?
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You may also be asked to describe yourself in a few words. Before your interview, consider asking a family member or close friend how they might describe you in a few words. This information can be very helpful.
Thank you for your consideration of the above information. I look forward to meeting with you!
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