Health Assessment Questionnaire
Electronic Filing Part 1
STOP BEFORE YOU START: This questionnaire requires PC computer and MS Internet Explorer ver. 8 or higher or Fire Fox ver. 8 or higher to be transmitted without errors. Using Apple/McIntosh computers or other browsers may transmit this questionnaire withdistortions or not transmit at all.
To be better prepared for your appointment we ask you to fill this Health Assessment Questionnaire which is the equivalent of about two-hour interview.
Our health improvement programs are entirely based on the use of natural substances, nutrition, exercises, and lifestyle adjustments specifically developed for individual clients. Under no circumstances we suggest, prescribe or otherwise indicate use of synthetic medicines as the health problems are not created by the deficiency of such. For more information who we are what we do click here
There is a fee of US$60.00 for the transmission and processing of this questionnaire. Will call you with the results. However, there is a fee for an appointment or telephone consultation. Estimated charges will be provided on request at the time of setting up the appointment.
Please pay the questionnaire processing fee using PayPal secure payment facility. After completing the payment you will be transferred to the questionnaire page.
Should you have any problems sending the payment and/or being connected to the questionnaire page, call the number or send email listed under "CONTACT" menu. We will attend to it promptly.

