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Holistic Therapy Ealing intake Forms

Covid screening pre treatment form

Covid safe, Acupuncture in Ealing

COVID-19 Pre appointment screening form

All new patients are required to fill in the screening form.
Please fill in this form the day before the appointment

Acupuncture intake form

Acupuncture in Ealing

Adult (19yo+) acupuncture intake form

 

Once we booked your appointment I would ask you to fill in an intake form, once completed, it would be automatically emailed to me. Please fill  this form day before the appointment.

If you are unable to do the online version, you could download PDF form (to print out and fill in)  or editable  Word; and fill it in and return before for your appointment.

Teenage (12-18yo) acupuncture intake form

Teenage acupuncture in Ealing
Teenage (12-18yo) acupuncture intake form
 

Once we booked the appointment I would ask young person and parents to fill in an intake form together, once completed, it would be automatically emailed to me.

Please fill in this online form, day before the appointment

Paediatric (0-12 yo) acupuncture intake form

Acupuncture for children in Ealing

Paediatric (0-11yo) acupuncture intake form

Once we have booked the appointment I will ask parents to fill in an intake form together with young person if age appropriate, once completed, it would be automatically emailed to me..

Please fill in this online form, day before the appointment.

If you are unable to do it, you could download PDF form (to print out and fill in)  or editable in Word;  fill it in and return before for your appointment.

Integral Eye Movement Therapy intake form
Integral Eye Movement Therapy

Integral Eye Movement form

Please fill in my online form.

Cognitive Hypnotherapy intake form
Hypnotherapy in Ealing

Cognitive Hypnotherapy forms

Please fill in the online agreement form For children and young people below 18yo please fill in the second part of the form.  After you submit it, it would be automatically emailed to me.

Additional monitoring forms

Please download and fill in this form (GAD-7, PHQ-9 &SWEMWBS) in Word or PDF to assess and monitor mental health.

To assess your Representational Preference System please fill this form in Word or PDF.

You can also check the strengths of your character on this  website
 

Homeobotanicals consultation form

Homeobotanicals in Ealing

Homeobotanicals consultation form

Please fill in my online Form.

Bach Flower consultation form

Bach flower in Ealing

Bach Flower consultation form

Please fill in my online Form.

Recommendations

Fertility and pregnancy supplements

Zita West, Acupuncture in Ealing

For excellent quality supplements I recommend Zita West's lane. Zita is an acupuncturist and a midwife who collaborated with nutritionists to develop her products. She has written a number of books on fertility and pregnancy, recorded a relaxation cd. Her products are made in UK (apart from CoQ10 - which is made in Germany) they support men and women in the preconception, fertility phases as well as pregnancy and postnatal period. If you follow this link you would receive 10% discount on all their products .

Exercises

Yoga and Pilates
Yoga with Adriene, Acupuncture in Ealing

As a part of lifestyle advice I often suggest Pilates or Yoga to my patients.

 

I have been attending Pilates classess with Michelle Kyles since 2018 and I can recommend her approach. You could contact her through her Facebook page

If you are looking for an online resources then Yoga with Adriene is a great place to start. She has a number of classes and meditation sessions available for free on her channel. Adriene's classes are very vibrant and uplifting.

If you are looking for more Yin - calm, slow online classes you could look into Paula's channel.

I have been doing classes with both Adriene and Paula, I love switching depending I need more energising or calming session.

Herbs

Chinese Medicine in Ealing

For Chinese Herbal Medicine I would highly recommend a fantastic teacher and principal of The White Crane Academy, Andrew Flower.

As well as Katie Scampton, who practices in Chiswick, she has been a senior lecturer at University of Westminister between 1999 and 2018. Both are excellent and experienced practitioners and are registered with the Register of Chinese Herbal Medicine. 

The herbal mixture comes in little sachets so you only need to add hot water and drink it, there is no need to boil the herbs.

Pain relief Ointment

Evil Bone Water for sale

For some time now I have been using traditional Chinese formula Zheng Xie Gu Shui (translated "Evil Bone Water")  It works to relief pain and reduce inflammation. I managed to get a shipment from USA and Evil Bone Water is now available in my store.

Research

Research data presented by Dr. Gil Barzilay Ph.D Dipl.CM (I.A.TCM, ETCMA) at a webinar in April 2020

  • Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. Andrew J. Vickers, PhD, Emily A. Vertosick, MPH, George Lewith, MD, Hugh MacPherson, PhD, Nadine E. Foster, DPhil, Karen J. Sherman, PhD, Dominik Irnich, MD, Claudia M. Witt, MD, and Klaus Linde, MD, on behalf of the Acupuncture Trialists’Collaboration 2018 May Results: Acupuncture is effective for the treatment of chronic musculoskeletal, headache, and osteoarthritis pain. Treatment effects of acupuncture persist over time and cannot be explained solely in terms of placebo effects. Referral for a course of acupuncture treatment is a reasonable option for a patient with chronic pain.

Research data presented by Dr Bartosz Chmielnicki MD at a webinar in April 2020 confirming efficacy of acupuncture to improve immunity: 

Research into Laser treatment

- Laser acupuncture in children with headache

Dr. Sven Gottschling from the University Children’s Hospital, Saarland University, Hamburg, Germany and a group of other European medical researchers teamed up to investigate the efficacy of low level laser acupuncture therapy treating children with migraines or tension headaches. They compared an active laser treatment to a placebo laser treatment in 43 children. This was a controlled, high quality study with randomization and double-blinding.

The average number of headaches per month decreased significantly more in the real laser acupuncture group (decrease of 6.4 days) than in the placebo group (decrease of 1.0 day). Headache severity and monthly hours with headache significantly decreased as well for the real laser acupuncture group compared to the placebo treatment.

The researchers concluded that low level infrared laser acupuncture can provide a significant benefit for children with headache or migraines.

- Laser Acupuncture Therapy for Primary Monosymptomatic Nocturnal Enuresis

Laser acupuncture therapy, a noninvasive, painless, short-term therapy with a low cost, can be considered as an alternative therapy for patients with primary monosymptomatic nocturnal enuresis.

- Therapeutic antioxidant and anti-inflammatory effects of laser acupuncture on patients with rheumatoid arthritis

This study results confirmed the effectiveness of laser acupuncture in alleviating oxidative stress and inflammation, improving antioxidant and energy metabolic status, while also suppressing the disease activity in RA patients. Laser acupuncture is a promising treatment modality to reduce the pain and suffering of RA patients because of its efficiency in inhibiting most of the main factors involved in the pathogenesis of this disease.

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