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Online Homeopathic Consultation - Step 1
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Please go through all the questions and answer them in great details even if you feel some of them are not exactly related to your condition. The more detailed you would be, the better we will be able to eveluate your condition and identify the best remedy for you.

 

*Full Name:

 
*Date Of Birth:
(Click on the textbox to choose date)

 
*Email Address:

 
*Gender
Male        Female 		*Marital status
Single        Married
*Do you smoke?
Yes everyday     Every Once In a While
Not at all 		*Do you drink?
Yes everyday     Every Once In a While
Not at all

*Your Weight: Kilograms  Pounds
*Your Height:  Feet    inches

 
Tell us about your work life.
I work...
from home     Desk job     Work on my feet (standing job)     Frequent traveler    
Retired     In School (Student)    

 
Complaint And History:
(If you have more than one problem, please state them in chronological order of their appearance)

 
Generalities

 
Are there any cause/causes for the start of your illness? (Physical / Mental / Emotional)

 
Significant family history of illness if any.

 
Tell us about your health status since childhood.

 
How is your appetite and thirst?

 
Cravings (The food you like the most)

 
Are there any food which seems to increase your problem? OR Do you have aversion to any food?
(like salt, sugar, spices, ioly food etc)

 
Any serious illness for which you have been hospitalized or had long term treatment?

 
Any treatment that is going on for the above complaint or any treatment for any other trouble?(Please mention medicine you are taking and dosage details)

 
Any history of hypertension/diabetes and treatment for the same?(Please mention medicine you are taking and dosage details)

 
What weather conditions suites you the best?

 
Do you perspire a lot? Any particular body part where you sweat a lot?

 
How is your bowel habit? How is your stool quality and regularity?

 
How is your sleep and its quality? Do you dream and if yes, what kind of dreams you get most often?

 
How will you describe yourself? Tell us your emotional disposition. How do you react to different situations in life?

 
Any other thing you want to share with us about you or your complaint?