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Romford & Ilford Family Chiropractic LtdTel: 020 8252 1010
313 High Road, Chadwell Heath
Romford, Essex RM6 6AX
www.chiropracticcare.co.uk
 WHERE IN YOUR BODY DO YOU HOLD OR CARRY YOUR STRESS?
 WHAT TOOLS HAVE YOU USED TO TRY TO REDUCE YOUR STRESS?
 WHY DO YOU THINK YOUR BODY FAILED TO HEAL ITSELF THIS TIME?
 DO YOU KNOW WHY YOUR BRAIN AND NERVOUS SYSTEM ARE
KNOWN AS THE MASTER CONTROL SYSTEM?
 TELL ME ABOUT THE 3 MOST SIGNIFICANT EMOTIONAL TRAUMAS IN
YOUR LIFE.
 HOW MANY HOURS DO YOU SLEEP ON AN AVERAGE EVENING?
 HOW WOULD YOU RATE YOUR LEVEL OF HAPPINESS ON A SCALE OF
1 – 10 WITH 10 BEING HIGHEST?
 IS MONEY A STRESS IN YOUR LIFE?
 WHAT IS CURRENTLY MISSING FROM YOUR LIFE?
Questionnaire:
Romford & Ilford Family Chiropractic LtdTel: 020 8252 1010
313 High Road, Chadwell Heath
Romford, Essex RM6 6AX
www.chiropracticcare.co.uk
 WHAT DO YOU THINK MIGHT LIE AT THE ROOT OF YOUR ILLNESS?
 WHAT ARE YOUR BELIEFS ABOUT HEALTH?
 WHAT ARE YOUR BELIEFS ABOUT ILLNESS?
 WHAT ARE YOUR BELIEFS ABOUT THE BODY BEING ABLE TO HEAL AND
REPAIR ITSELF?
 WHAT IS THE MAIN FOCUS TODAY?

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Re exam questionnaire use this one

  • 1. Romford & Ilford Family Chiropractic LtdTel: 020 8252 1010 313 High Road, Chadwell Heath Romford, Essex RM6 6AX www.chiropracticcare.co.uk  WHERE IN YOUR BODY DO YOU HOLD OR CARRY YOUR STRESS?  WHAT TOOLS HAVE YOU USED TO TRY TO REDUCE YOUR STRESS?  WHY DO YOU THINK YOUR BODY FAILED TO HEAL ITSELF THIS TIME?  DO YOU KNOW WHY YOUR BRAIN AND NERVOUS SYSTEM ARE KNOWN AS THE MASTER CONTROL SYSTEM?  TELL ME ABOUT THE 3 MOST SIGNIFICANT EMOTIONAL TRAUMAS IN YOUR LIFE.  HOW MANY HOURS DO YOU SLEEP ON AN AVERAGE EVENING?  HOW WOULD YOU RATE YOUR LEVEL OF HAPPINESS ON A SCALE OF 1 – 10 WITH 10 BEING HIGHEST?  IS MONEY A STRESS IN YOUR LIFE?  WHAT IS CURRENTLY MISSING FROM YOUR LIFE? Questionnaire:
  • 2. Romford & Ilford Family Chiropractic LtdTel: 020 8252 1010 313 High Road, Chadwell Heath Romford, Essex RM6 6AX www.chiropracticcare.co.uk  WHAT DO YOU THINK MIGHT LIE AT THE ROOT OF YOUR ILLNESS?  WHAT ARE YOUR BELIEFS ABOUT HEALTH?  WHAT ARE YOUR BELIEFS ABOUT ILLNESS?  WHAT ARE YOUR BELIEFS ABOUT THE BODY BEING ABLE TO HEAL AND REPAIR ITSELF?  WHAT IS THE MAIN FOCUS TODAY?