Health Consultation
M D Chaudhry, Pharmacist, Registered Homoeopathic Practitioner and Registered Medical Herbalist
Homepage About me: my qualifications and experience Your health My therapy Consultation: have an online consultation Contact me

IMPORTANT How to receive your consultation: Please complete the consultation form below with as much information as possible. Please note there is a fee of £50 for your consultation, plus the cost of medication. After you have completed and sent your consultation form, please pay through our payment page here. I cannot offer a consultation until your fee has been received. Your details will be treated confidentially and no information will be divulged to any third party
First Name
Last Name
Address
Email
Please type in your complete email address like this:
myname@host.com

Present symptoms
(please describe in detail)

 

Aetiology
(i.e. when symptoms started and how)
Modalities
(factors that make your symptoms a) worse
and b) improve your symptoms)

   
Present medication (both from your doctor and self-medication)
Past medication
Medical History from childhood (list all details)
Family History of any serious illnesses (going back to parents and grandparents on both paternal and maternal sides)
Any traumas and shocks (both psychological and physical)
Fear and phobias
Any other information

Please submit only ONCE

   

 
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