Online Consultation

 AGN Ayurveda EISRA


Contact Location
Thijssestraat 16,
2521 ZL Den Haag, Nederland

Contact Numbers
Tel.:  070 - 319 25 46
Fax:  070 - 414 08 18

E-mail
info@AyurvedaActueel.com

 

Please provide us the following details to get the Online Consultation. Please note that accuracy of details provided by you will help us understanding the issue better. Once we have received the details in the below mentioned form submitted by you, we will get back to you with the desired information asap...

Please note that an asterisk * denotes required field.
* Name:
 
Date of Birth:
* Gender:
 
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Occupation:
Describe your family history in brief
(profession, and diseases):
Do your disease symptoms decrease or increase when you change places having different climates?
Give details about your addictions/cravings,
if any, like tea, coffee, alcohol, sugar, smoking etc.
What are the medicines you are taking at present?
* Question / Health Problem Query:
Describe the intensity of the problem?
When does the intensity decrease by its own accord? Which factors do you feel trigger it?
What types of treatments and medicines have you taken so far? What have been the results? Have you observed any side effects?
How would you rate yourself emotionally?
What time do you usually go to sleep?
When do you wake up?
How are your dreams?
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