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RECOMMENDED
READING
|
HEALTH
APPRAISAL
NAME:
Date:
|
Dry
skin |
|
Biliousness |
|
Laxative often used |
|
Skin
rashes frequently |
|
Greasy foods upset |
|
History of gall stones |
|
Bitter, metallic taste in mouth in morning |
|
Stools light coloured |
|
Sneezing attacks |
|
Bowel
movements painful or difficult |
|
|
|
|
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Lower
bowel gas several hours after eating |
|
Coated tongue |
|
Gas
shortly after eating |
|
Burning stomach sensation relieved by eating |
|
Indigestion ½ - 1 hour after eating, or up to 3 – 4 hours |
|
Stomach bloating after eating |
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Pulse
fast at rest |
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Low
blood pressure |
|
Hot
flushes |
|
Nervousness |
|
Failing memory |
|
Headaches |
|
Can’t
gain weight |
|
Increased sex drive |
|
Dizziness |
|
Intolerance to heat |
|
Splitting headaches |
|
Increase in blood pressure |
|
Highly emotional |
|
Decrease sugar tolerance |
|
Sugar
in urine |
|
Flush
easily |
|
|
|
Masculine tendencies (women) |
|
Night
sweats |
|
|
|
Low
blood pressure |
|
Inward trembling |
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Intestinal bloating |
|
Chronic fatigue |
|
Heart
palpitates |
|
Abnormal thirst |
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Weakness dizziness |
|
Insomnia |
|
Weight gain (hips or waist) |
|
Tendency to hives |
|
Impaired hearing |
|
Sex
desire reduced |
|
Arthritic tendencies |
|
Decrease appetite |
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Tendency to ulcers, colitis |
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Perspiration increase |
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Ringing in ears |
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Increased sugar tolerance |
|
Crave
salt |
|
Constipation |
|
Women: menstrual disorder |
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Brown
spots / brown skin |
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Mental sluggishness |
|
Young
girls: lack of menstruation |
|
Allergies, asthma |
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Headaches on waking |
|
|
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Exhaustion – muscular, nervous |
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Slow
pulse |
|
|
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Respiratory disorders |
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Weight gain |
|
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|
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Open the Word document:
Health
Appraisal Questionnaire - page 3
Questionnaire page 1
Questionnaire page 2
Questionnaire page 3
Questionnaire page 4
|

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980 3447
What
our patients say...
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