Initial Eczema Consultation

Initial Consultation
Name
Name
First Name
Last Name
Where do you live
What do you live in
What are your main issues?
Tick the eczema symptoms you are experiencing:
What ‘mainstream’ approaches have you tried?
Allergy check
Have you experienced any of these health issues (last 6 mths)?
Which of these modalities have you tried?
Digestive function
How is the stool’s consistency as per the Bristol Stool Chart:
Microbiome check
What foods do you avoid? (Please don’t take this as a list to adopt)
Histamine metabolism check
Nutrient balance check
Do you smoke?
Exposure to toxins
Do you take any supplements?
What investments have you made: