Case Results form
Please use this form to provide your data for understanding and records. Only for cases treated by Dr Kondekar
total duration of Goal directed treatment taken with Dr kondekar *
eye contact after 3 months of medicines *
no
very very very good
date of birth of child *
MM
/
DD
/
YYYY
Any aspects you feel Dr didnot pay attention to:
positive response is seen within how many days of treatment *
Mobile number of parent *
please list what all new unwanted changes u noted in your child which were not there before starting Dr kondekars protocol *
please list what all new good changes u noted in your child which were not there before starting Dr kondekars protocol *
when i visited Dr Kondekar my child had *
yes
no
dont know
improved upto 20 %
improved 20 to 40%
improved 40 to 60 %
improved more than 80%
no improvement
speech delay
hyperactvity
sensory issues
constipation
low IQ
no speech
no body language
no imitation
no communication
biting
hitting
object obsessions
shouting
not studying
not writing
epilepsy
genetic diagnosis
social communicaion deficit
autism
other issues
no eye contact
partial eye contact
no understanding
not independent
stimming
the speed of response with Dr Kondekars protocol is approximately *
list if any side effects you noted with doctors medicines also mention how mild or serious the side effect you have seen in your child
would u like to continue treatment with Dr Kondekar further? *
Full Name of child and address *
any more suggestions to Dr Kondekar regarding improving the child
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