If you want online Homeopathic Consultation from us then Fill The Form no.1 of Chief complaint Accurately—
the answers given by you will guide us to select your medicines.
The answers given by you will be kept confidential.
The amount payable will be sent to you by e-mail .
We will courier you your medicines.
Form no.1 (includes basic details and chief complaints)
Please fill all these details and send to my e-mail id by click on Form no.1.
BASIC DETAILS
ANS.
Form no.2 (this includes your family history, medical past history, in females menses history, your further details etc., this form will be sent to you by us after reading your form no.1, the set of questions in form no2 will be decided by type of your disease in form no1.)
Please fill all these details and send to my e-mail id by click on Form no.1.
BASIC DETAILS
Full Name:-_______________________
Age:- ________________________
Sex:- _________________________
Qualification:- __________________
Occupation:- ___________________
Address:- __________________
Phone Number Landline:-
Mobile:-
Marrital Status:-
Date Of Birth:-
Height:-
Weight:-
If Patient is Child Write Birth Weight :-
CHIEF COMPLAINT
1] What Troubles You The Most Right Now For Which You Need Homeopathic Medicines?
ANS.
2] When Did This Complaint Begin? Any Thing Happened in your life around that time? Have You Recognised any cause that caused it?
ANS.
3] What are the factors that worsen and intesifies your chief complaint?
ANS.
4] What are the things or factors that help you in relieving the complaint?
EXP. Acidity --- Relieved by Cold milk.
Itching --- Relieved by Cold Water application..
Knee Pain--- Relieved by Warm application.
5] Have you identified any Symptom /Symptoms that accompany your chief complaint?
ANS.
6] Are you having any other Disease? For which you are taking any treatment? Which Drugs are you taking Please mention..
ANS.
Form no.2 (this includes your family history, medical past history, in females menses history, your further details etc., this form will be sent to you by us after reading your form no.1, the set of questions in form no2 will be decided by type of your disease in form no1.)
