Questionnaire

Homeopathy Questionnaire

Step 1 of 5

20%
  • Address is required if you want a homeopathic remedy to be posted to you. Enter the address to which your remedy should be sent. Please give the full address including postcode.
  • Please enter phone number without spaces
  • The main medical condition(s) with which you need help.
  • How long have you suffered from the condition? Did anything happen in your life just before it began (such as an operation, an illness, a change in medication, a bereavement)?
  • Describe anything that affects the condition. Examples: worse in the morning, better when heat applied, worse after eating fruit, worse in cold weather.