Health Analysis Questionaire

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Full Name*

Email*

Phone number or telegram username*

What is your biggest concern in your body right now?*

What body ailments are you experiencing right now? (Send up to 3 separate reflections you want this read on) or if you have a diagnosis (include diagnose and all symptoms your experiencing)*

What have you already tried that has given you some or little to no relief (energetic or physical), if anything*

If you're on any medications, please list them here if you feel comfortable. I like to cross check to avoid any negative medication-herb interactions*

Do you have any allergies?*

I am so excited to be working with you!!

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