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Image by Bethany Fidanzo

Pre-Consultation.

Once you've booked your appointment, it's important that you complete and submit the health questionnaire below before we meet. This will enable me to tailor the best possible treatment to suit your needs. All answers will, of course, be treated with the strictest of confidence.

Before arrival, please ensure to have clean feet and remove any nail polish.

Pre-Consultation

Health Questionnaire

Please fill out and return the following form
before attending your appointment.

Do you experience, or have you experienced, any of the following?
(Simply click No/Yes to answer.)
Musculoskeletal conditions

For example: arthritis, osteoporosis/penia, past fractures, hypermobility, tendonitis, gout, fibromyalgia, ankylosing spondylitis, sciatica

Respiratory conditions

For example: asthma, COPD, bronchitis, allergies, pulmonary hypertension, tuberculosis

Digestive Disorders

For example: IBS, Crohn's disease, coeliac disease, diverticulitis, constipation, GERD, liver/gallbladder issues

Circulatory issues

For example: high/low blood pressure, heart disease, angina, arrythmia, stroke, Reynaud's syndrome, high cholesterol, DVT, phlebitis, varicose veins, glaucoma

Endocrine disorders

For example: diabetes, hyper/po thyroidism, PCOS, PMT, menstrual problems, menopause, pregnancy, reproductive issues, low testosterone, prostate

Autoimmune disorders

For example: rheumatoid arthritis, lupus, psoriasis, Addison's disease, Graves' disease, allergies, MS, long COVID, chronic fatigue syndrome

Urinary conditions

For example: kidney stones, kidney/bladder infections, incontinence, enlarged prostate

Skin conditions

For example: eczema, psoriasis, warts, verrucas, athlete's foot, acne, rosacea, vitiligo

Nervous system disorders

For example: epilepsy, Parkinson's disease, MS, Alzheimer's

Mental health conditions

For example: stress, anxiety, depression, insomnia, eating disorders

Are you having or have you had treatment for cancer?
Are you currently on any medication?
Recent surgery
Imminent medical tests or procedures

Thanks for submitting!

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