you currently receiving medical or therapeutic care, on
any medications, taking supplements, or scheduled for
is helpful to have a timeline of injuries, illness, and
interventions that you have experienced. Please list
those below. The following questions are
• That you are aware of, did
you experience any birth trauma?
you vaccinated or medicated as a child? Did you have any
• Did you have any head
injuries, even concussions or falls?
Any car accidents?
• Any major dental
• Were you ever hospitalized?
health of your parents and family members is also
important. Please share any available information
regarding the following:
• Your mother’s pregnancy
• Any illnesses or traumas experienced by
parents, siblings or other relatives
else that you feel is important can go below. We will
discuss your health on a deep level, so use this for a
brief outline of additional topics and we will be sure
to cover these in our consultation.
What is your preferred method of payment? We accept
Zelle, Venmo, Credit Cards online, as well as Cash,
Check, Gold, Silver, and BTC by arrangement.