I

What brings you here this season?

II

Are you currently taking any prescription medications?

Yes No

III

Are you pregnant, breastfeeding, or trying to conceive?

Yes No Not applicable

IV

Do you have any diagnosed conditions we should know about?

V

Do you have any known allergies — to plants, foods, or topical products?

VI

How would you describe your energy at the moment?

Depleted and slow to recover Reasonably steady but not quite right Reasonably well but wanting seasonal support Good — looking to maintain and optimise

VII

Are you drawn more to internal preparations (tonics, teas) or topical and aromatic ones (balm, salve, mists) — or both?

Internal Topical and aromatic Both Not sure yet

VIII

How did you find the practice?

Health Screen