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Get a free health check from one of our phytotherapists. Fill out the following questionnaire and then press the SUBMIT button.

This step will help the phytotherapist better understand your state of health and discuss your specific problem.

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 Osteoarthritis Arthritic pain Rheumatic pain Muscular inflammation Back pain

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 Cholesterol Blood glucose level Venous insufficiency Cardiovascular health

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 Allergies Bronchitis Cough

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 Loss of appetite Bloating Slow digestion Indigestion Flatulence Constipation Gastritis              Healthy liver functioning

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 Stress Insomnia Nervousness

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 Urinary infection Elimination of toxins Healthy intestinal flora






For a quick and efficient response, all fields marked with an asterisk (*) must be completed.

*Name

*Address

*City

*Postal code

*Phone number

*Email address

Other symptoms and/or information

IMPORTANT : The information and observations contained in this document are not intended to replace medical advice given by your doctor. Readers must regularly consult their doctors for all information regarding their personal medical problems, including diagnoses, treatments and other physical and mental conditions.

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