PRE-CONSULTATION FORM

High blood pressure, high cholesterol & triglycerides along with palpitations on being stressful or anxious sometimes

PCOD/PCOS ( polycystic ovary )

Obesity & Over-weight

Too thin/ under-weight

Dandruff, itching & dull dry hair

Dandruff, scaly scalp, itching & oily hair

Excessive skin dryness

Low Energy & tiredness

Low Immunity & easily prone to seasonal changes or seasonal infections like cold, cough or flu

Poor Digestion & upset stomach problems

Lack of sleep / insomnia

Excessive hair fall or thinning

Sensitivity to cold weather

Joint pain, stiffness, cracking sounds in joints

Muscle twitching, spasms, tremors

Unintentional weight loss or difficulty gaining weight

Irregular digestion, bloating, excessive gas, constipation

Weak or low appetite (fluctuates often)

Insomnia, disturbed sleep, difficulty falling asleep

Rapid, shallow breathing

Menstrual irregularities (scanty, painful, or irregular periods)

Restlessness, hyperactivity

Anxiety, worry, excessive overthinking

Forgetfulness, poor memory, lack of focus

Mood swings, nervousness, fearfulness

Feeling overwhelmed or scattered

Impulsive decisions, lack of consistency

Easily distracted, difficulty completing tasks

Speech becomes fast, unclear, or erratic

Excess body heat, feeling hot often

Excessive sweating with a strong odor

Skin issues like acne, rashes, redness, inflammation, boils

Oily skin and scalp, prone to breakouts

Sensitivity to sunlight, sunburns easily

Early graying or thinning of hair

Acid reflux, hyperacidity, heartburn

Loose stools, diarrhea, or frequent bowel movements

Excessive hunger and thirst

Strong cravings for spicy, salty, and fried foods

Strong body odor or bad breath

Yellowish discoloration of skin or eyes

Sharp, penetrating eyesight (but prone to redness, irritation, or burning sensation)

High energy levels, but prone to sudden exhaustion

Prone to headaches and migraines

Light sleep, often wakes up due to heat or dreams

Irritability, anger, short temper

Perfectionism, high expectations of self and others

Intense competitiveness, over-ambition

Impatience, intolerance to mistakes

Judgmental or critical behavior

Prone to jealousy and resentment

Obsessive focus, difficulty relaxing

Strong willpower but burnout due to overwork

Weight gain, difficulty losing weight

Sluggish digestion, slow metabolism

Feeling heavy, lethargic, sleepy throughout the day

Frequent congestion, sinus issues, mucus buildup

Water retention, swelling in hands, feet, puffiness on face

Excessive salivation, thick coating on the tongue

Low appetite but still prone to weight gain

Nausea or sluggish digestion after meals

Oily skin, prone to cystic acne

Greasy or thick hair, excess oil production on scalp

Cold body temperature, intolerance to cold and damp weather

Frequent colds, cough, allergies, asthma, respiratory issues

Sleepiness, difficulty waking up in the morning

Slow but steady energy throughout the day

Feeling emotionally heavy, lack of enthusiasm

Depression, sadness, withdrawal from activities

Attachment to people, things, and habits

Resistance to change, difficulty letting go

Over-indulgence in food, especially sweet and comfort foods

Procrastination, lack of motivation

Brain fog, slow thinking, difficulty processing information

Excessive sleep, oversleeping, feeling tired even after rest

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