Health Check

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Problems pertaining to the Head area	Headaches migraine light-headedness feeling of fullness in head fainting excessive drowsiness sleepiness after eating loss of memory long term memory problems concentration difficulties mental dullness cloudy or foggy thinking mental lethargy/ fatigue confusion excessive daydreaming pituitary problems loss of hair no problem at all
Problems pertaining to the Eye	Sensitivity to light Loss of vision Blurred vision Night vision problems itchy, watery, inflamed tired eyes bloodshot eyes eye pain darkness under eyes puffy eyes wears glasses wears sunglasses daily none at all
Problems Related To Ears	Hearing Loss Loss of Balance Dizziness Ringing in Ears Earache and Pain Itching Ear Ear Drainage Fluid in Middle Ear Recurrent ear Infection Oversensitivity to sound
Do you have any of the following nose related problems?	Loss of smell Runny nose Excessive mucus formation Nose Bleeds Nose Pain Oversensitivity to smells Recurrent sinusitis/ sinus problems None of the above.
Any problems related to the mouth?	Cold Sores/Cancer Sores Bleeding Gums Painful Gums Itchiness on the Roof of the mouth Loss of taste Oversensitive to taste Odour in mouth upon waking Grind teeth in sleep Dental problems Toothache Root canal Mercury Amalgam Slurred Speech Stuttering None of the above
Any problems related to the throat?	Hoarse or sore throat Dryness in Throat Chronic cough Gagging Difficulty in swallowing Lump in throat Tonsilitis Swollen Glands Goitre Thyroid Imbalance None of the above.
Any problems related to neck?	Stiff neck Neck pain Whiplash lack of mobility in neck none of the above
Any menstrual problems?(for female patients only)	Menstrual cramps and pain Heavy Period Blood clots Irregularity of cycle Menopausal or hot flushes PMS or mood swings None of the above
Problems related to shoulders and arms -	Shoulder Pain Upper arm pain Elbow pain Wrist pain Prickling sensation in hands Numbness in fingers Cold hands Swollen Fingers Stiffness and soreness in fingers Sweaty hands Dry Hands None of the above.
Problems of the Immune System	Frequent colds or flus Food Allergies Environmental Allergies Strong body odour Lymph Problems None of the above.
Problems of the Lungs	Difficulty in breathing Shortness of breath Chronic cough Chronic phlegm and mucus Tightness in chest Chest pain Infections Asthma Bronchitis and Pneumonia Emphysema None of the above.
Heart and Breast Area problems	Heart Palpitations Heart rate 86-100 beats per minute Trachycardia over 100 beats per minute Chest congestion Breast tenderness Cyst in breast area Muscle weakness Joint aches and pains Muscle aches and pains Hypertension Passivity and lethargy High Blood Pressure None of the above
Stomach Area Problems	Digestive problems Acid reflex Ulcers Ingestions Abdominal pains or cramps Feeling of Nausea Vomitting Constipation Diarrhoea Bloating of/ Bloated Stomach Feeling of fullness in stomach long after eating Liver problems Hepatitis Diabetes Hypoglycemia Gallstones Nervousness Ringworm Parasites High Toxin Levels Colitis Salt Craving Sweet craving Herpes Poor work habits None of the above
Problems related to Kidneys	Pain during urination Frequent urination Difficulties in urination Water Retention Strong Odour in urine Discoloration in urine Swelling of the hands, feet or ankles None of the above.
Problems related to Skin	Rashes or sores Pallour Eczema Dernatitis or psoriasis Bruise skin easily tender areas itchy skin excessive dry skin sensitivity to touch none of the above
Problems related to Reproductive Organs	Bloating Frequent Yeast infection vaginal itching vaginal discharge problem conceiving emotional instability eating disorders binge or spree eating Excessive hunger Alcohol craving Drug abuse Hard stools Muscle cramps and spasms dizziness allergies hypersensitive to environment and night sweating None of the above
Problems related to the Back	Pain between the shoulder blades lower back pain muscle spasm in the back spinal meningitis none of the above
Problems related to legs and feet.	Pain in Buttocks Pain in Hip joints Numbness in leg/feet Cold feet Swollen ankles or feet Pain in feet Ankle/ knee problems varicose veins circulation problems none of the above

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CAREFULLY FILL OUT THE QUESTIONNAIRE GIVEN BELOW FOR A DETAILED REPORT ON THE STATE OF YOUR HEALTH. {COST = CAD$20.00 PAYMENT TO BE MADE BY PAYPAL TO A/C OF angelo.desouza@hotmail.com}