Online Consultation

Please answer the questions below in as much detail as you are able. Please ignore any questions which do not seem pertinent. However, the more information you provide will help Dr. Ajit assess your condition correctly.

Once you have filled out the online consultation form, you will receive some preliminary diet & lifestyle recommendations to start incorporating into your daily life.

You can get more comprehensive & detailed advice from Dr Ajit by joining our Path to Health™ programme.  He will provide a detailed programme, covering all the aspects of your health concerns.

All information provided is totally confidential & not disclosed to any third parties.
 
Before you begin we recommend you take the Know Your Body type test to establish your constitution.

First Name *	Last Name *
Email Address *	Present occupation
Please add me to your newsletter email list Please send me details of products which are appropriate to my body type Please send me details of special offers which are appropriate to my body type	According to the Know Your Body type test, my constitution is
Please give a brief description of any health problems you have & how long they have existed?	Do you take any supplements or medication? (List them please)
Describe your lifestyle in a few words (eg. Stressful or relaxed etc	What is important to you in your life?
What sort of weather do you like?	How is your memory? (Both short & long term)
Please give a brief description of any health problems you have experienced in the past 5 years.	Are there any health problems experienced by your siblings, parents or grandparents?
What do you normally eat for breakfast?	What do you normally eat for lunch?
What do you normally eat for dinner?	What do you snack on between meals?
How long does it take before you become hungry again?	Do you feel bloated after eating?
Do you experience any flatulence? (If yes, are they smelly?)	How much water do you drink each day?
Do you drink alcohol? (If yes, how much)	Do you smoke? (If yes, how often)
Do you find it easy to gain or lose weight or do you remain constant?	Are your nails brittle, soft, tough or bitten & do they have any white spots or ridges?
How often do you urinate & what is its usual colour and consistency?	How often do you have a bowel motion & what is its usual colour and consistency?
Is your tongue dry or moist?	Is your skin dry or oily
Do you sweat easily?	Is your face smooth or wrinkled?
Are your eyes moist or dry?	Is there any other information you would like to share that relates to your health?
Enter Word Verification in box below *

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