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BALANCED HEALTH NATURALLY ABN 34891705391 Jeannette Scapens (AdvDip. Naturopathy) 0439828669 balancedhealthnaturally@gmail.com Client details and history
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Have you experienced any major losses in your life? If so, please comment *
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Medications *
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Family History
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Tell me a little about your diet
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What things about your health are currently concerning you? *
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When did you first experience these health concerns and was anything major going on in your life at the time? *
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Have you tried any other treatments for these concerns? Please comment
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Have you experienced success with these approaches?
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What other health professionals are you currently seeing?
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In a few words, tell me about your sleep
Do you sleep well? Do you have trouble getting to sleep or staying asleep? Do you wake up tired or feeling refreshed? How many hours of sleep do you get each night?
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What is your digestion like?
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Do you have allergies?
Tell me about the symptoms, what causes your allergies, how badly the allergies affect you
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If you are female, tell me about your hormones
Are you pre-menopausal, menopausal, or post-menopausal? If you still have periods, are they regular? Do you have pain with your periods? Do you suffer from PMS? What form of contraception are you using? Do you suffer from endometriosis, fibroids, ovarian cysts? What else do I need to know about your hormones?
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What are your energy levels like?
What are your stress levels like?
Do you get sick often?
What are your top 3 health goals?
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