New Patient history: Adults Please fill in as much of this form as you can and tick where appropriate.
Your body is designed to be healthy. There is always a cause or reason as to why it is not.
All the information you supply here will be handled in strict confidence. The answers will help us assess any layers of damage, particularly to your nervous system, that have adversely affected your health.
Areas marked with * must be filled in.
To use this form you must enter a valid email address.