Fibromyalgia Questionnaire - HomeopathicVibes

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Our Address: 940 E El Camino Real, Sunnyvale, CA - 94087 | 39039 Paseo Padere Parkway,Suite #209,Fremont, CA 94538

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Fibromyalgia Questionnaire

Why Me?

I'm providing homeopathic services for over 20 years in entire California. My clinic is located in Sunnyvale, Fremont, and San Jose. I have treated more than 1000 patients suffering from various conditions. I also provide online consultation if you're not able to visit any of my clinics. I have more than 100 five stars reviews on Google, Yelp, and other reviews websites. If you would like to know more about me, then feel free to reach me out by phone.

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Fibromyalgia Questionnaire

940 E. El Camino Real
Sunnyvale, CA 94087
harminder@homeopathicvibes.com
www.homeopathicvibes.com
Office Phone (408)737-7100
Office Fax (408)737-7102

Name *

First

Last

Email *

Did you ever been clinically diagnosed conditions (check all that apply):

I have deep, sharp, dull, throbbing, or aching pain all over my body that doesn't go away?

Yes
No

I have difficulty sleeping because of chronic pains?

Yes
No

I am constantly tired and inattentive during daytime hours?

Yes
No

I have widespread, deep muscle pain and stiffness when I wake up.

Yes
No

I have painful trigger points or localized areas of tenderness around joints that hurt when pressed?

Yes
No

My pain is so unbearable that I feel anxious and depressed?

Yes
No

I feel pain throughout my body that results in forced bed rest, along with loss of activity and income?

Yes
No

I am unable to exercise and be active so I spend a lot of time alone?

Yes
No

I have painful menstrual cramps and pelvic pain.( for women only)

Yes
No

Chronic fibromyalgia pain has forced me to not to enjoy the things I enjoyed in the past?

Yes
No

Chronic fibromyalgia pain has forced me to leave my job?

Yes
No

Chronic fibromyalgia pain has forced me do daily activities like cooking, cleaning etc?

Yes
No

This pain has affected my job and performance at work?

Yes
No

I have sensitivity to bright lights?

Yes
No

My skin is prone to pimples, acne and other outbreaks?

Yes
No

Phone

About Me

I have passion for homeopathy. I am blessed to be born in family of Homeopaths. My grand father Dr. Hazara Singh Gill was great homeopath of his times. He did his M.B.H (Bachelor of Medicine in Homeopathy) from Punjab Homeopathic Medical College Lahore in 1925.

Sunnyvale Location

Phone: 408-737-7100
Fax: 408-737-7102
Address: 940 E El Camino Real, Sunnyvale, CA 94087, United States
harminder@homeopathicvibes.com

Fremont Location

Phone: 408-737-7100
Fax: 408-737-7102
Address: 39039 Paseo Padere Parkway,Suite #209,Fremont, CA 94538, USA.
harminder@homeopathicvibes.com

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