Blue Pearl Ayurveda Health Questionnaire
Please fill out the health information completely so that valuable consultation time does not have to be spent gathering health information.
Please take some time to think through your full range of health issues by completing the following questionnaire. Many times seemingly unrelated health problems are all caused by the same doshic imbalance, a fact often not recognized by Western medicine. Ayurveda can address all of your issues simultaneously and improve your overall quality of life.
Please submit your completed questionnaire to Blue Pearl Ayurveda at least 24 hours prior to your scheduled appointment so that I can review it before we speak.
Please attach a recent photograph of yourself if you have one available that can be sent by email to the address above.
I look forward to working together with you to improve your health.
Thomas Mitchell, D.C.