Magnetic Pulsing

Before an appointment, you will need to complete a consultation document.

Please complete the consultation form below or telephone 07837 303109 for a copy

to be sent to you by email or post 

CONSULTATION DOCUMENT

Do any of the following relate to you?  

Pregnant?

Transplant patient?  

Electrical implant?

Active Cancer patient?

THESE ARE THE ONLY CONTRA-INDICATIONS WHEN USING PEMFT AND REGRETABLY TREATMENTCANNOT BE OFFERED

Name. *
Full Address. *
Telephone Number. *
Email Address. *
Age?
Gender?	Male Female
Weight.
Height.
Describe your problem?
How long have you had it?
What are your aims?
Describe smoking habits?
Describe drinking habits?
Describe eating habits?
Any food addictions?
Any weight problems?
How do you sleep?
Do you suffer from any stress?
Describe your family?
Describe yourself?
Any questions?

Contact:  magneticpulsing@btinternet.com