Fibromyalgia-Chronic Fatigue-Pain Clinic

Breakthrough treatment that restores the body's health naturally

Questionnaire

*What is your name *Where are you located (i.e. Worcester UK) *Have you already been diagnosed with Chronic Fatigue or Fibromyalgia
Yes
No
*Do you suffer with Pain
Yes
No
If you suffer from Pain, what type of pain do you have? i.e. arthritis etc; *Do you suffer from any of the following
A feeling of fatigue (severe tiredness)
Does the fatigue affect your normal physical and mental functions
Has the fatigue been present for more than 6 months
Is the fatigue present all the time
Do you suffer from muscle aches (particularly after physical exertion)
Do you suffer from mood swings (feeling depressed and emotional)
Do you suffer from nausea and loss of appetite
Do you suffer from disturbed sleep or not feeling refreshed after sleep
Do you suffer from sore throats or feeling faint and dizzy
Do you run slightly high temperatures for no apparent reason
Have you any other symptoms that are not listed above
*Have you been checked out medically by your GP
Yes
No
If you have been checked out by your GP what was his/her findings
*Your email address Your email address and details are kept confidential, in a secure environment and will not be passed onto a third party