Dr. Goel - Homoeopathic Clinic
Consultation Form

Please fill in this case record form in as great detail as possible. Fill in all relevant details. Things that you might feel are “medically not relevant” can give important information, such as your habits, patterns of behaviors, moods etc. Of particular importance are changes that you have noticed recently, in appetite, in desire or aversion for particular foods, in behaviors, sleep patterns, bowel habits, dreams etc., so please report any such details that you have noticed.

ALL INFORMATION SUBMITTED BY YOU SHALL BE ABSOLUTELY CONFIDENTIAL.

Read Instructions for submitting Case History

Download Case History form for adults, and email your case history to sumitgoel@yahoo.com

In case of children, download Case form for children.

Kindly note that we have to seek more information if found necessary.

[A direct one-to-one communication between a physician and a patient is the best form of a clinical interview and an online consultation has its limitations.
The consultants offering the Treatment on-line will not be responsible for the course of events during the period of treatment, which may be due to a variety of factors.
The homoeopathic treatment, per se, is essentially harmless and safe.
This site does not provide medical or any other health care advice, diagnosis or treatment. The site and its services are for informational purposes only and are not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your homoeopath or other qualified health professional before starting any new treatment or making any changes to existing treatment. Do not delay seeking or disregard medical advice based on information on this site.]

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