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Wellness Coaching
Seminars
'Food better than Medicine'
Blog 'Living with Herbs'
Deine Kräuterei
come in
Home
Shop
Wellness Coaching
Seminars
'Food better than Medicine'
Blog 'Living with Herbs'
Deine Kräuterei
Questionnaire
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Name
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First
Last
Email
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Experiencing irregular cycles? Since when?
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Since when are you experiencing pre-menopausal symptoms? Please note how many days/weeks/months/years
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What kind of symptoms do you experience?
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Having a hard time falling asleep
Poor sleep (waking up during the night)
Fatigue / loss of energy
Mood swings
Anxiety
Irritability
Sugar Craving
Weight gain (several pounds during last 3 month)
Water Retention (puffy eyes)
Experiencing hot flashes or night sweats
What did you try so far to relieve the symptoms? Please put down what you tried, for how long, and what your experience was.
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You may put it down in a word document and upload the file.
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Max file size: 20MB
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Please put down what you eat for one week. Please be as specific as you can, every bite and every ingredient you are aware of. Then upload file, please.
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Max file size: 20MB
How about exercise? I exercise...
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almost never
once in a while
once a week
up to 3 times a week
almost every day
Submit
