European Natural Health Center
Imagine Health. Naturally

Polish/Polski kwestionariusz

Health Assessment Questionnaire

Electronic Filing Part 1

 

NOTICE: This questionnaire requires MS Internet Explorer ver. 8 or higher to be transmitted without errors.  Using other browsers may transmit this questionnaire with distortions or not transmit at all. 

To be better prepared for your appointment we ask you to fill this Health Assessment Questionnaire which is the equivalent of about two-hour interview. 

 

Our health improvement programs are entirely based on the use of natural substances, nutrition, exercises, and lifestyle adjustments specifically developed for individual clients.  Under no circumstances we suggest, prescribe or otherwise indicate use of synthetic medicines as the health problems are not created by the deficiency of such.  For more information who we are what we do click here

 

There is a fee of US$49.95 for the transmission and processing of this questionnaire (US$75.00 if filed by fax) plus an additional fee for an appointment or telephone consultation.  Estimated office charges will be provided on request at the time of setting up the appointment. 

 

Please pay the questionnaire processing fee using PayPal secure payment facility.  After completing the payment you will be transferred to the questionnaire page.

Should you have any problems sending the payment and/or being connected to the questionnaire page, call the number or send email listed at the bottom of this page.  We will attend to it promptly.