Sakota Homeopathy Personal Intake Form
This form is to give me a picture of your individual mental, emotion and physical states of health. This includes symptoms that affect both physical sensations (what does it feel like), and function (how it impacts you) and what aggravates each symptom. Please complete this form carefully and take the time to answer the questions to the best of your self-knowledge. Each question will support me to get a "whole picture" of your personal health.
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