Ulcerative Colitis 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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Ulcerative Colitis 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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Ulcerative Colitis 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 *

Do you have abdominal pain on your lower left side?

Yes
No

Do you have bloating before a bowel movement or passing gas?

Yes
No

Do you have abdominal tenderness?

Yes
No

Do you have blood in your stools?

Yes
No

Have you been experiencing nausea and/or vomiting?

Yes
No

Have you been experiencing constipation?

Yes
No

Have you been experiencing diarrhea?

Yes
No

Have you been experiencing both constipation and diarrhea?

Yes
No

Do you feel as if you have to have another bowel movement soon after having one?

Yes
No

Do you have mucus or pus in your stools?

Yes
No

Is your pain alleviated after a bowel movement?

Yes
No

Is your pain on the lower right side of the abdomen just below the bellybutton?

Yes
No

Do you have any surgeries recently?

Yes
No

How many flare ups you have had recently in last 12 months?

Yes
No

How many times you were on steroids in last 12 months?

Yes
No

Have you consulted some Homeopathic or alternative consultant recently?

Yes
No

Explain how long and where?

Comment

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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