Welcome!  I look forward to working with you.  Please take a few minutes to answer the questionnaire below to the best of your ability.  It's really important to provide a thorough history prior to getting started.  We're both making an investing in your wellness so just answer as honestly as possible.  IF you have questions or aren't sure, just make a note in the answer section and we can go over it when we talk live.

Name *
Include medicine / supplements / food
- next to each issue indicate - Mild / Moderate / Severe - - also indicate any prior treatment or approach to resolving issue
If so, how much & how often?
If above a 2 make a list of stressors you can control and those you can not.
This doesn't have to be perfect, but be as specific as possible - include snacks and beverages.