This is the questionnaire you need to complete if you would like Allium Healing to test your hair sample; when you submit the completed questionnaire you will be directed to the ‘Initial Testing‘ product in our shop to make payment

Questionnaire - Human
If female, are you pregnant?
Do you drink? *
Are you aware you may have to limit your coffee/tea drinking while on treatment? *
Are you currently on any medication? *
If yes, what time(s) of day do you take medication?
Have you read the full information on the website and are you aware that you could go back through old symptoms while you are going through treatment? *
Are you willing to go through this in order to bring about healing? *
Are you aware that although we do the most thorough test possible on your first test, things may change as treatment progresses and it is possible for us to retest if required and alter your remedies at any point to support you? *
Are you aware that you should NOT be taking any other homeopathy during treatment? However we can suggest and/or supply other remedies providing you are tested first.. *
I confirm that I wish Allium Healing to test my hair sample and understand that no promises of cure have been made. It does not replace medical advice. I am responsible for any withdrawal of medication prescribed to me by my doctor. I confirm I have read the privacy statement and agree to my details being kept *
Where did you hear about Allium Healing? *
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