Quick, easy and completely natural

With the Medication Free Headache Management method you can prevent, stop, and reduce the frequency, duration, and intensity of your headaches and migraines, within minutes.

To start your pain free life, please fill out this 6 question short questionnaire. The answers are checked every evening but if you need faster solution message Barbara on +32.483.158.630


Sign in to Google to save your progress. Learn more
Your full name *
Your GSM number *
Your best email address *
How often do you have headaches or migraines? Daily, weekly, monthly? *
Since how long are you suffering from headaches and migraines? Can you remember how many days, weeks, months or years ago it started? *
How long do the headache or migraine episodes last? *
Required
What is the intensity of your headaches or migraines on a scale of 1 to 10? *
Required
Is there anything else I need to know of your situation? *
How old are you? It stays between us, like all the above ;) *
*
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy