Health History and Status
Sleep and Energy
i.e. coffee, chocolate, tea, energy drinks, pills, etc.
Play is any actvity you enjoy that isn't intended to achieve a goal or a predetermined outcome. These can be physical activities, social activities, hobbies, games, etc.
The more information you can provide now, the more prepared we'll be to address your issues in our appointment.
For these next few questions, fill in the blank with whatever first comes to mind:
Since those questions resonated with you, here are a few more that may stimulate some more personal discovery.
We understand. Let's move on to something else!
The Natural World
That's actually more time than most people.
We'd like to understand more about your relationship with the natural world. Indicate your resonance with the following statements, where 1 = strongly disagree and 10 = strongly agree
Wow, that's great - tell us more!
Indicate your resonance with the following statements, where 1 = strongly disagree and 10 = strongly agree
Last but certainly not least, list the first names of the most important relationships (family, friend, or colleague) in your life:
To the best of my knowledge, the information provided above is true and accurate. I agree to tell WeHeal, Inc. any changes to my health history or medications as they arise. I understand that information is necessary for WeHeal, Inc. and will remain confidential. All efforts are routinely made to ensure privacy is upheld.