Need help-SNH 510 – Case Studies in Natural Medicine


Need help-SNH 510 – Case Studies in Natural Medicine

SNH 510 – Case Studies (preset data)

NOTE: Please read ALL instructions for this assignment before you begin

Description: Case studies are designed to demonstrate the cumulative knowledge of a natural health practitioner in a practical manner.

For this course requirement, students will interpret predetermined data from fictitious clients and make professional recommendations accordingly. Detailed analyses of these case studies by the student should demonstrate a full ability to apply natural health concepts and modalities to address client needs and concerns. Provided content: • 3 case studies from Trinity with information already filled out • A list of questions to be completed for each case study • A blank certification sheet Instructions: Students should be able to interpret and respond to the information presented in the case study documents. Recommendations should be fully explained and easily supported by the student. 1. Review provided case studies (For each case provided, assume the person came to you with only this information and would not provide any more answers or allow testing) 2. Determine logical and supportable lifestyle changes, supplements or body work 3. For each case study, provide answers to all of the listed student questions 4. Complete the attached certification sheet Once all documentation has been completed: Scan and email the documents to casestudies@trinityschool.org OR Mail the final documents to Trinity School of Natural Health Attn: Case Studies 220 Parker St. Warsaw, IN 46580 Note: Submit all final documentations together. Incomplete submissions will not be reviewed *If you have any questions on anything provided in the packet please call: (574) 267-6111 Student Questions Instructions: Type your answers on a separate page to the following questions. Provide as much detail as possible. A set of answers should be submitted for each case study in this assignment. Please retype the question prior to adding your answer. Questions: 1. What is the client’s name? (This will allow Trinity to link your answers with the correct intake form.) 2. What core issues might be involved in this case and why? 3. How would you explain the cause of each of the symptoms to the client? 4. What is the most serious concern from your perspective? 5. With regard to the symptoms and information gathered, did anything seem contradictory or not make sense in your opinion? 6. What further questions would you like to ask the client? 7. Based on the information provided, what are your recommendations? 8. Prioritize your recommendations – from most important to least. 9. What results would you expect the client to notice in the first week? 10.What results would you expect the client to notice in the second week? 11. What results would you expect the client to notice by the end of 30 days? 12.Does the dosage or recommendations change over 30 days? Provide details. 13.How long should they follow these recommendations? 14.When should another consultation be scheduled, if any? 15.When should follow up happen from you or them? 16.Should the client seek out licensed medical assistance? 220 Parker Street, Warsaw, IN 46580 • 1-800-428-0408 • http://www.trinityschool.org Trinity School of Natural Health 220 Parker St., Warsaw, IN 46580 1-800-428-0408 http://www.trinityschool.org Certification Sheet for SNH 510 Case Studies (Preset Data) Certification I certify that the research and coursework supplied to this requirement were the results of my own study and not those of others. I understand that if I am collaborating with another person, we will submit our own coursework, and the content for this requirement is my original work. I also understand that if found to be identical to the coursework of another student (in part or in whole), I could be asked to resubmit all new coursework. Print Name: ___________________________________________________________________ Address — include Street Address (or PO Box), City, State and Zip: _____________________________________________________________________________ _____________________________________________________________________________ Phone Number: _______________________________________________________________ Email Address: ________________________________________________________________ Signature: ____________________________________________________________________ Please fill out this form completely and attach it with your other coursework before you turn it in for grading. We must have this form to accept your submission for grading. Individual Health Information Sheet Name___________________________________________________ Day Phone _________________________________ Address _________________________________________________ Night Phone _______________________________ City ____________________________________________________ Cell Phone _________________________________ State/Zip ________________________________________________ Email _____________________________________ Relief from what top 3 symptoms (see back page) __________________________________________________________ Life Goals___________________________________________________________________________________________ How much sweaty activity weekly? ___________________________ What type of activity? ________________________ How many ounces of water do you drink daily? _________________ What type? RO Tap Spring Distilled    Which meals daily eaten? Breakfast Lunch Supper How many eliminations per day? _______________ How many digestive enzymes daily? __________________________ How many breathing exercises daily? ___________ How much of the following do you consume? (example, 1D = once daily, 3M = 3 times monthly) Soda pop _________ Coffee ________ Smoking ___________ Alcoholic Bev __________ Fast food _________ Milk___________ White Flour _________ Sugar usage ___________ Raw fruit__________ Meat __________ Raw Veggies ________ Whole Grains __________ What types of food do you crave? Salty Chocolate    Sweets Breads    Other ____________________________ What are your favorite foods? __________________________________________________________________________ How much daily energy (1 = lowest energy level; 10 = highest energy level) do you have? __________________________ What surgeries have you had and when? Circle NONE if applicable. ____________________________________________ ___________________________________________________________________________________________________ How many hours of TV do you watch? Daily___________________ Weekly____________________________________ How many hours of spiritual enrichment each week? (Bible, prayer, church, etc.)__________________________________ How many hours a week do you spend with family/friends? __________________________________________________ How many hours of sleep do you get each night? _______________ How many hours do you need? ________________ What kind of prescription medication do you take?  Circle NONE if applicable. ___________________________________ ___________________________________________________________________________________________________ Would you like to receive our natural health newsletter?     YES    NO Who referred you for your appointment today? ____________________________________________________________ I understand that I am here to learn about nutrition and better health practices and that I will be offered information about food supplements and herbs as a guide to general good health and this is a personal ministry and spiritual counseling. I fully understand that those who counsel me are not medical doctors and I am not here for medical diagnostic purposes or treatment procedures.  I am not on this visit or any subsequent visit an agent for federal, state, or local agencies or on a mission of entrapment or investigation.   The services performed here are at all times restricted to consultation on nutritional matters intended for the maintenance of the best possible state of natural health and do not involve the diagnosing, treatment, or prescribing of remedies for disease. Signature________________________________________________ Date ______________________________________ Daniel James 555-555-5555 7813 Hugart Road 555-555-5555 Orlando 555-555-5555 FL, 25446 Daniel.James@emailme.com Stress, fatigue and ear ringing Faith, servant leader, family, health and joy 1 weekly Running 24 oz 1 daily 0 none 1 monthly 0 0 0 2 weekly 1 daily ? ? 4 weekly 2 daily 1 weekly ? Chicken, fish, fruit and ice cream 5 1.5 hours 12 hours 5 hours 40 hours 7.5 8 Zyrtec Dan James 05/06/2014 Symptoms and Areas of Concern (check all that apply) Acne Circulation Hiatal Hernia Pneumonia ADD/ADHD Cold – Common Hives Polyps Adrenal Glands Cold – Temperature Hormones Pregnancy Allergies Colic Hyperactive Prostate Alzheimer’s Disease Colon Hypertension Psoriasis Anemia Constipation Hyperthyroidism Rash Anger Cough Hypoglycemia Reproductive Anxiety Cravings Impotence Respiratory Appetite Dandruff Incontinence Rheumatism Arteriosclerosis Depression Indigestion Ring worm Arthritis Diabetes Insomnia Seizures Asthma Diarrhea Joint Pain Shingles Back Pain Digestion Kidney Issues Sinus Bad Breath Dizzy Spells Kidney Stones Skin Issues Bed Wetting Ear Infection Laryngitis Snoring Bell’s Palsy Ear Ringing Leprosy Sore Throat Bites Edema Leukemia Stomach Bladder Emphysema Liver Stress Blood Pressure – High Epilepsy Lung Issues Stroke Blood Pressure – Low Eyesight Lupus Sty Boils Fatigue Lymph Glands Teething Bones Fever Menopause Tennis Elbow Breathing Flu Menstrual Cramps Tonsillitis Bronchitis Gallstones Migraines Tumors Bruises Gangrene Mononucleosis Ulcers Burns Gas Mucous Urinary Infections Cancer Gout Nails Varicose Veins Candida Gums Nausea Vertigo Canker Sores Hair Issues Nervousness Weight – Overweight Carpal Tunnel Headache Nose Bleeds Weight – Underweight Cataracts Heart Issues Parasites Yeast Infections Chest Congestion Heartburn Parkinson’s Disease OTHER: Chest Pain Hemorrhoids Perspiration Cholesterol Herpes PMS Dan James Bach Flower Self-Help Questionnaire Check all that apply. If you have to think about it, skip it. Don’t limit your choices. Agrimony ___I hide my feelings behind a facade of cheerfulness ___I dislike arguments and often give in to avoid conflict ___I turn to food, work, alcohol, drugs, etc. when down Aspen ___I feel anxious without knowing why ___I have a secret fear that something bad will happen ___I wake up feeling anxious Beech ___I get annoyed by the habits of others ___I focus on others’ mistakes ___I am critical and intolerant Centaury ___I often neglect my own needs to please ___I find it difficult to say “no” ___I tend to be easily influenced Cerato ___I constantly second-guess myself ___I seek advice, mistrusting my own intuition ___I often change my mind out of confusion Cherry Plum ___I’m afraid I might lose control of myself ___I have sudden fits of rage ___I feel like I’m going crazy Chestnut Bud ___I make the same mistakes over and over ___I don’t learn from my experience ___I keep repeating the same patterns Chicory ___I need to be needed and want my loved ones close ___I feel unloved and unappreciated by my family ___I easily feel slighted and hurt Clematis ___I often feel spacey and absent minded ___I find myself unable to concentrate for long ___I get drowsy and sleep more than necessary Crab Apple ___I am overly concerned with cleanliness ___I feel unclean or physically unattractive ___I tend to obsess over little things Elm ___I feel overwhelmed by my responsibilities ___I don’t cope well under pressure ___I have temporarily lost my self-confidence Gentian ___I become discouraged with small setbacks ___I am easily disheartened when faced with difficulties ___I am often skeptical and pessimistic Gorse ___I feel hopeless, and can’t see a way out ___I lack faith that things could get better in my life ___I feel sullen and depressed Dan James Mustard ___I get depressed without any reason ___I feel my moods swinging back and forth ___I get gloomy feelings that come and go Oak ___I tend to overwork and keep on in spite of exhaustion ___I have a strong sense of duty and never give up ___I neglect my own needs in order to complete a task Olive ___I feel completely exhausted, physically and/or mentally ___I am totally drained of all energy with no reserves left ___I’ve just been through a long period of illness or stress Pine ___I feel unworthy and inferior ___I often feel guilty ___I blame myself for everything that goes wrong Red Chestnut ___I’m overly concerned and worried about my loved ones ___I’m distressed and disturbed by other people’s problems ___I worry that harm may come to those I love Rock Rose ___I sometimes feel terror and panic ___I become helpless and frozen when afraid ___I suffer from nightmares Rock Water ___I set high standards for myself ___I am strict with my health, work &/or spiritual discipline ___I am very self-disciplined, always striving for perfection Heather ___I am obsessed with my own troubles ___I dislike being alone and I like to talk ___I usually bring conversations back to myself Holly ___I am suspicious of others ___I feel discontented and unhappy ___I am full of jealousy, mistrust, or hate Honeysuckle ___I’m often homesick for the “way it was” ___I think more about the past than the present ___I often think about what might have been Hornbeam ___I often feel too tired to face the day ahead ___I feel mentally exhausted ___I tend to put things off Impatiens ___I find it hard to wait for things ___I am impatient and irritable ___I prefer to work alone Larch ___I lack self-confidence ___I feel inferior and often become discouraged ___I never expect anything but failure Mimulus ___I am afraid of things such as spiders, illness, etc. ___I am shy, overly sensitive, and modest ___I get nervous and embarrassed Dan James White Chestnut ___I am constantly thinking unwanted thoughts ___I repeatedly relive unhappy events or arguments ___I’m unable to sleep at times because I can’t stop thinking Wild Oat ___I can’t find my path in life ___I am drifting in life and lack direction ___I am ambitious but don’t know what to do Wild Rose ___I am apathetic and resigned to whatever happens ___I have the attitude, “It doesn’t matter anyhow” ___I feel no joy in life Willow ___I feel resentful and bitter ___I have difficulty forgiving and forgetting ___I think life is unfair and have a “Poor me attitude” Scleranthus ___I find it difficult to make decisions ___I often change my opinions ___I have intense mood swings Star of Bethlehem ___I feel devastated due to a recent shock ___I am withdrawn due to traumatic events in my life ___I have never recovered from loss or fright Sweet Chestnut ___I feel extreme mental or emotional heartache ___I have reached the limits of my endurance ___I am in complete despair, all hope gone Vervain ___I get high-strung and very intense ___I try to convince others of my way of thinking ___I am sensitive to injustice, almost fanatical Vine ___I tend to take charge of projects, situations, etc. ___I consider myself a natural leader ___I am strong-willed, ambitious and often bossy Walnut ___I’m experiencing change in life–a move, new job, etc. ___I get drained by people or situations ___I want to be free to follow my own ambitions Water Violet ___I give the impression that I’m aloof ___I prefer to be alone when overwhelmed ___I often don’t connect with people Determining Your Custom Remedy After completing the questionnaire, circle the remedy names where two or more checks appear to determine which remedies are needed. Try to limit the number of remedies to six or fewer by choosing only the ones that are needed. Dan James pH Levels Sugars ________________ Urine pH ______________ Saliva pH ______________ Salts__________________ Cell Debris_____________ Nit Nit ________________ Amm Nit ______________ Total Ureas ____________ Notes Eye Photo Tongue Photo Nail Photo 6 5.4 7.2 40c 4m+ 9 11 20 Dan James Individual Health Information Sheet Name___________________________________________________ Day Phone _________________________________ Address _________________________________________________ Night Phone _______________________________ City ____________________________________________________ Cell Phone _________________________________ State/Zip ________________________________________________ Email _____________________________________ Relief from what top 3 symptoms (see back page) __________________________________________________________ Life Goals___________________________________________________________________________________________ How much sweaty activity weekly? ___________________________ What type of activity? ________________________ How many ounces of water do you drink daily? _________________ What type? RO Tap Spring Distilled    Which meals daily eaten? Breakfast Lunch Supper How many eliminations per day? _______________ How many digestive enzymes daily? __________________________ How many breathing exercises daily? ___________ How much of the following do you consume? (example, 1D = once daily, 3M = 3 times monthly) Soda pop _________ Coffee ________ Smoking ___________ Alcoholic Bev __________ Fast food _________ Milk___________ White Flour _________ Sugar usage ___________ Raw fruit__________ Meat __________ Raw Veggies ________ Whole Grains __________ What types of food do you crave? Salty Chocolate    Sweets Breads    Other ____________________________ What are your favorite foods? __________________________________________________________________________ How much daily energy (1 = lowest energy level; 10 = highest energy level) do you have? __________________________ What surgeries have you had and when? Circle NONE if applicable. ____________________________________________ ___________________________________________________________________________________________________ How many hours of TV do you watch? Daily___________________ Weekly____________________________________ How many hours of spiritual enrichment each week? (Bible, prayer, church, etc.)__________________________________ How many hours a week do you spend with family/friends? __________________________________________________ How many hours of sleep do you get each night? _______________ How many hours do you need? ________________ What kind of prescription medication do you take?  Circle NONE if applicable. ___________________________________ ___________________________________________________________________________________________________ Would you like to receive our natural health newsletter?     YES    NO Who referred you for your appointment today? ____________________________________________________________ I understand that I am here to learn about nutrition and better health practices and that I will be offered information about food supplements and herbs as a guide to general good health and this is a personal ministry and spiritual counseling. I fully understand that those who counsel me are not medical doctors and I am not here for medical diagnostic purposes or treatment procedures.  I am not on this visit or any subsequent visit an agent for federal, state, or local agencies or on a mission of entrapment or investigation.   The services performed here are at all times restricted to consultation on nutritional matters intended for the maintenance of the best possible state of natural health and do not involve the diagnosing, treatment, or prescribing of remedies for disease. Signature________________________________________________ Date ______________________________________ Kayla Brown 555-555-5555 1526 South Hampton Street 555-555-5555 Plymouth 555-555-5555 IN, 46019 Kayla.Brown@emailme.com Stress, neck and back pain Live a life honoring to God and to serve others 2 times a week Zumba, Walking 80 1 time 4 – 1 monthly 0 0 0 1 weekly 0 3 weekly 1 daily 3 weekly 4 weekly 2 weekly 2 monthly Pizza, tacos and salads 8 2 hours 14 hours 2 hours 1 hour 6-7 8 Kayla Brown 08/23/2013 Symptoms and Areas of Concern (check all that apply) Acne Circulation Hiatal Hernia Pneumonia ADD/ADHD Cold – Common Hives Polyps Adrenal Glands Cold – Temperature Hormones Pregnancy Allergies Colic Hyperactive Prostate Alzheimer’s Disease Colon Hypertension Psoriasis Anemia Constipation Hyperthyroidism Rash Anger Cough Hypoglycemia Reproductive Anxiety Cravings Impotence Respiratory Appetite Dandruff Incontinence Rheumatism Arteriosclerosis Depression Indigestion Ring worm Arthritis Diabetes Insomnia Seizures Asthma Diarrhea Joint Pain Shingles Back Pain Digestion Kidney Issues Sinus Bad Breath Dizzy Spells Kidney Stones Skin Issues Bed Wetting Ear Infection Laryngitis Snoring Bell’s Palsy Ear Ringing Leprosy Sore Throat Bites Edema Leukemia Stomach Bladder Emphysema Liver Stress Blood Pressure – High Epilepsy Lung Issues Stroke Blood Pressure – Low Eyesight Lupus Sty Boils Fatigue Lymph Glands Teething Bones Fever Menopause Tennis Elbow Breathing Flu Menstrual Cramps Tonsillitis Bronchitis Gallstones Migraines Tumors Bruises Gangrene Mononucleosis Ulcers Burns Gas Mucous Urinary Infections Cancer Gout Nails Varicose Veins Candida Gums Nausea Vertigo Canker Sores Hair Issues Nervousness Weight – Overweight Carpal Tunnel Headache Nose Bleeds Weight – Underweight Cataracts Heart Issues Parasites Yeast Infections Chest Congestion Heartburn Parkinson’s Disease OTHER: Chest Pain Hemorrhoids Perspiration Cholesterol Herpes PMS Kayla Brown Bach Flower Self-Help Questionnaire Check all that apply. If you have to think about it, skip it. Don’t limit your choices. Agrimony ___I hide my feelings behind a facade of cheerfulness ___I dislike arguments and often give in to avoid conflict ___I turn to food, work, alcohol, drugs, etc. when down Aspen ___I feel anxious without knowing why ___I have a secret fear that something bad will happen ___I wake up feeling anxious Beech ___I get annoyed by the habits of others ___I focus on others’ mistakes ___I am critical and intolerant Centaury ___I often neglect my own needs to please ___I find it difficult to say “no” ___I tend to be easily influenced Cerato ___I constantly second-guess myself ___I seek advice, mistrusting my own intuition ___I often change my mind out of confusion Cherry Plum ___I’m afraid I might lose control of myself ___I have sudden fits of rage ___I feel like I’m going crazy Chestnut Bud ___I make the same mistakes over and over ___I don’t learn from my experience ___I keep repeating the same patterns Chicory ___I need to be needed and want my loved ones close ___I feel unloved and unappreciated by my family ___I easily feel slighted and hurt Clematis ___I often feel spacey and absent minded ___I find myself unable to concentrate for long ___I get drowsy and sleep more than necessary Crab Apple ___I am overly concerned with cleanliness ___I feel unclean or physically unattractive ___I tend to obsess over little things Elm ___I feel overwhelmed by my responsibilities ___I don’t cope well under pressure ___I have temporarily lost my self-confidence Gentian ___I become discouraged with small setbacks ___I am easily disheartened when faced with difficulties ___I am often skeptical and pessimistic Gorse ___I feel hopeless, and can’t see a way out ___I lack faith that things could get better in my life ___I feel sullen and depressed Kayla Brown Mustard ___I get depressed without any reason ___I feel my moods swinging back and forth ___I get gloomy feelings that come and go Oak ___I tend to overwork and keep on in spite of exhaustion ___I have a strong sense of duty and never give up ___I neglect my own needs in order to complete a task Olive ___I feel completely exhausted, physically and/or mentally ___I am totally drained of all energy with no reserves left ___I’ve just been through a long period of illness or stress Pine ___I feel unworthy and inferior ___I often feel guilty ___I blame myself for everything that goes wrong Red Chestnut ___I’m overly concerned and worried about my loved ones ___I’m distressed and disturbed by other people’s problems ___I worry that harm may come to those I love Rock Rose ___I sometimes feel terror and panic ___I become helpless and frozen when afraid ___I suffer from nightmares Rock Water ___I set high standards for myself ___I am strict with my health, work &/or spiritual discipline ___I am very self-disciplined, always striving for perfection Heather ___I am obsessed with my own troubles ___I dislike being alone and I like to talk ___I usually bring conversations back to myself Holly ___I am suspicious of others ___I feel discontented and unhappy ___I am full of jealousy, mistrust, or hate Honeysuckle ___I’m often homesick for the “way it was” ___I think more about the past than the present ___I often think about what might have been Hornbeam ___I often feel too tired to face the day ahead ___I feel mentally exhausted ___I tend to put things off Impatiens ___I find it hard to wait for things ___I am impatient and irritable ___I prefer to work alone Larch ___I lack self-confidence ___I feel inferior and often become discouraged ___I never expect anything but failure Mimulus ___I am afraid of things such as spiders, illness, etc. ___I am shy, overly sensitive, and modest ___I get nervous and embarrassed Kayla Brown White Chestnut ___I am constantly thinking unwanted thoughts ___I repeatedly relive unhappy events or arguments ___I’m unable to sleep at times because I can’t stop thinking Wild Oat ___I can’t find my path in life ___I am drifting in life and lack direction ___I am ambitious but don’t know what to do Wild Rose ___I am apathetic and resigned to whatever happens ___I have the attitude, “It doesn’t matter anyhow” ___I feel no joy in life Willow ___I feel resentful and bitter ___I have difficulty forgiving and forgetting ___I think life is unfair and have a “Poor me attitude” Scleranthus ___I find it difficult to make decisions ___I often change my opinions ___I have intense mood swings Star of Bethlehem ___I feel devastated due to a recent shock ___I am withdrawn due to traumatic events in my life ___I have never recovered from loss or fright Sweet Chestnut ___I feel extreme mental or emotional heartache ___I have reached the limits of my endurance ___I am in complete despair, all hope gone Vervain ___I get high-strung and very intense ___I try to convince others of my way of thinking ___I am sensitive to injustice, almost fanatical Vine ___I tend to take charge of projects, situations, etc. ___I consider myself a natural leader ___I am strong-willed, ambitious and often bossy Walnut ___I’m experiencing change in life–a move, new job, etc. ___I get drained by people or situations ___I want to be free to follow my own ambitions Water Violet ___I give the impression that I’m aloof ___I prefer to be alone when overwhelmed ___I often don’t connect with people Determining Your Custom Remedy After completing the questionnaire, circle the remedy names where two or more checks appear to determine which remedies are needed. Try to limit the number of remedies to six or fewer by choosing only the ones that are needed. Kayla Brown Notes Eye Photo Tongue Photo Nail Photo pH Levels Sugars ________________ Urine pH ______________ Saliva pH ______________ Salts__________________ Cell Debris_____________ Nit Nit ________________ Amm Nit ______________ Total Ureas ____________ .3 6.9 6.6 4m+ 1 5 Kayla Brown Individual Health Information Sheet Name___________________________________________________ Day Phone _________________________________ Address _________________________________________________ Night Phone _______________________________ City ____________________________________________________ Cell Phone _________________________________ State/Zip ________________________________________________ Email _____________________________________ Relief from what top 3 symptoms (see back page) __________________________________________________________ Life Goals___________________________________________________________________________________________ How much sweaty activity weekly? ___________________________ What type of activity? ________________________ How many ounces of water do you drink daily? _________________ What type? RO Tap Spring Distilled    Which meals daily eaten? Breakfast Lunch Supper How many eliminations per day? _______________ How many digestive enzymes daily? __________________________ How many breathing exercises daily? ___________ How much of the following do you consume? (example, 1D = once daily, 3M = 3 times monthly) Soda pop _________ Coffee ________ Smoking ___________ Alcoholic Bev __________ Fast food _________ Milk___________ White Flour _________ Sugar usage ___________ Raw fruit__________ Meat __________ Raw Veggies ________ Whole Grains __________ What types of food do you crave? Salty Chocolate    Sweets Breads    Other ____________________________ What are your favorite foods? __________________________________________________________________________ How much daily energy (1 = lowest energy level; 10 = highest energy level) do you have? __________________________ What surgeries have you had and when? Circle NONE if applicable. ____________________________________________ ___________________________________________________________________________________________________ How many hours of TV do you watch? Daily___________________ Weekly____________________________________ How many hours of spiritual enrichment each week? (Bible, prayer, church, etc.)__________________________________ How many hours a week do you spend with family/friends? __________________________________________________ How many hours of sleep do you get each night? _______________ How many hours do you need? ________________ What kind of prescription medication do you take?  Circle NONE if applicable. ___________________________________ ___________________________________________________________________________________________________ Would you like to receive our natural health newsletter?     YES    NO Who referred you for your appointment today? ____________________________________________________________ I understand that I am here to learn about nutrition and better health practices and that I will be offered information about food supplements and herbs as a guide to general good health and this is a personal ministry and spiritual counseling. I fully understand that those who counsel me are not medical doctors and I am not here for medical diagnostic purposes or treatment procedures.  I am not on this visit or any subsequent visit an agent for federal, state, or local agencies or on a mission of entrapment or investigation.   The services performed here are at all times restricted to consultation on nutritional matters intended for the maintenance of the best possible state of natural health and do not involve the diagnosing, treatment, or prescribing of remedies for disease. Signature________________________________________________ Date ______________________________________ Ruth Mullikin 555-555-5555 643 Meridian Street 555-555-5555 Indianapolis 555-555-5555 IN, 46970 Ruth.Mullikin@emailme.com Joint Pain, Stress and menopause Be happy, healthy and strong 1-2 hours Walking 60+ 1-2 times 6+ 0 0 3 monthly 0 0 3-4 monthly 0 1 monthly 1 daily 4-5 weekly 1 daily 4-5 weekly 0 Eggs, corn chips, salads, turkey and chicken 5 Ovarian cyst 2 hours 12-14 hours 6 hours 24 – 7 8 6-8 Ruth Mullikin 09/29/2014 Symptoms and Areas of Concern (check all that apply) Acne Circulation Hiatal Hernia Pneumonia ADD/ADHD Cold – Common Hives Polyps Adrenal Glands Cold – Temperature Hormones Pregnancy Allergies Colic Hyperactive Prostate Alzheimer’s Disease Colon Hypertension Psoriasis Anemia Constipation Hyperthyroidism Rash Anger Cough Hypoglycemia Reproductive Anxiety Cravings Impotence Respiratory Appetite Dandruff Incontinence Rheumatism Arteriosclerosis Depression Indigestion Ring worm Arthritis Diabetes Insomnia Seizures Asthma Diarrhea Joint Pain Shingles Back Pain Digestion Kidney Issues Sinus Bad Breath Dizzy Spells Kidney Stones Skin Issues Bed Wetting Ear Infection Laryngitis Snoring Bell’s Palsy Ear Ringing Leprosy Sore Throat Bites Edema Leukemia Stomach Bladder Emphysema Liver Stress Blood Pressure – High Epilepsy Lung Issues Stroke Blood Pressure – Low Eyesight Lupus Sty Boils Fatigue Lymph Glands Teething Bones Fever Menopause Tennis Elbow Breathing Flu Menstrual Cramps Tonsillitis Bronchitis Gallstones Migraines Tumors Bruises Gangrene Mononucleosis Ulcers Burns Gas Mucous Urinary Infections Cancer Gout Nails Varicose Veins Candida Gums Nausea Vertigo Canker Sores Hair Issues Nervousness Weight – Overweight Carpal Tunnel Headache Nose Bleeds Weight – Underweight Cataracts Heart Issues Parasites Yeast Infections Chest Congestion Heartburn Parkinson’s Disease OTHER: Chest Pain Hemorrhoids Perspiration Cholesterol Herpes PMS Ruth Mullikin Bach Flower Self-Help Questionnaire Check all that apply. If you have to think about it, skip it. Don’t limit your choices. Agrimony ___I hide my feelings behind a facade of cheerfulness ___I dislike arguments and often give in to avoid conflict ___I turn to food, work, alcohol, drugs, etc. when down Aspen ___I feel anxious without knowing why ___I have a secret fear that something bad will happen ___I wake up feeling anxious Beech ___I get annoyed by the habits of others ___I focus on others’ mistakes ___I am critical and intolerant Centaury ___I often neglect my own needs to please ___I find it difficult to say “no” ___I tend to be easily influenced Cerato ___I constantly second-guess myself ___I seek advice, mistrusting my own intuition ___I often change my mind out of confusion Cherry Plum ___I’m afraid I might lose control of myself ___I have sudden fits of rage ___I feel like I’m going crazy Chestnut Bud ___I make the same mistakes over and over ___I don’t learn from my experience ___I keep repeating the same patterns Chicory ___I need to be needed and want my loved ones close ___I feel unloved and unappreciated by my family ___I easily feel slighted and hurt Clematis ___I often feel spacey and absent minded ___I find myself unable to concentrate for long ___I get drowsy and sleep more than necessary Crab Apple ___I am overly concerned with cleanliness ___I feel unclean or physically unattractive ___I tend to obsess over little things Elm ___I feel overwhelmed by my responsibilities ___I don’t cope well under pressure ___I have temporarily lost my self-confidence Gentian ___I become discouraged with small setbacks ___I am easily disheartened when faced with difficulties ___I am often skeptical and pessimistic Gorse ___I feel hopeless, and can’t see a way out ___I lack faith that things could get better in my life ___I feel sullen and depressed Ruth Mullikin Mustard ___I get depressed without any reason ___I feel my moods swinging back and forth ___I get gloomy feelings that come and go Oak ___I tend to overwork and keep on in spite of exhaustion ___I have a strong sense of duty and never give up ___I neglect my own needs in order to complete a task Olive ___I feel completely exhausted, physically and/or mentally ___I am totally drained of all energy with no reserves left ___I’ve just been through a long period of illness or stress Pine ___I feel unworthy and inferior ___I often feel guilty ___I blame myself for everything that goes wrong Red Chestnut ___I’m overly concerned and worried about my loved ones ___I’m distressed and disturbed by other people’s problems ___I worry that harm may come to those I love Rock Rose ___I sometimes feel terror and panic ___I become helpless and frozen when afraid ___I suffer from nightmares Rock Water ___I set high standards for myself ___I am strict with my health, work &/or spiritual discipline ___I am very self-disciplined, always striving for perfection Heather ___I am obsessed with my own troubles ___I dislike being alone and I like to talk ___I usually bring conversations back to myself Holly ___I am suspicious of others ___I feel discontented and unhappy ___I am full of jealousy, mistrust, or hate Honeysuckle ___I’m often homesick for the “way it was” ___I think more about the past than the present ___I often think about what might have been Hornbeam ___I often feel too tired to face the day ahead ___I feel mentally exhausted ___I tend to put things off Impatiens ___I find it hard to wait for things ___I am impatient and irritable ___I prefer to work alone Larch ___I lack self-confidence ___I feel inferior and often become discouraged ___I never expect anything but failure Mimulus ___I am afraid of things such as spiders, illness, etc. ___I am shy, overly sensitive, and modest ___I get nervous and embarrassed Ruth Mullikin White Chestnut ___I am constantly thinking unwanted thoughts ___I repeatedly relive unhappy events or arguments ___I’m unable to sleep at times because I can’t stop thinking Wild Oat ___I can’t find my path in life ___I am drifting in life and lack direction ___I am ambitious but don’t know what to do Wild Rose ___I am apathetic and resigned to whatever happens ___I have the attitude, “It doesn’t matter anyhow” ___I feel no joy in life Willow ___I feel resentful and bitter ___I have difficulty forgiving and forgetting ___I think life is unfair and have a “Poor me attitude” Scleranthus ___I find it difficult to make decisions ___I often change my opinions ___I have intense mood swings Star of Bethlehem ___I feel devastated due to a recent shock ___I am withdrawn due to traumatic events in my life ___I have never recovered from loss or fright Sweet Chestnut ___I feel extreme mental or emotional heartache ___I have reached the limits of my endurance ___I am in complete despair, all hope gone Vervain ___I get high-strung and very intense ___I try to convince others of my way of thinking ___I am sensitive to injustice, almost fanatical Vine ___I tend to take charge of projects, situations, etc. ___I consider myself a natural leader ___I am strong-willed, ambitious and often bossy Walnut ___I’m experiencing change in life–a move, new job, etc. ___I get drained by people or situations ___I want to be free to follow my own ambitions Water Violet ___I give the impression that I’m aloof ___I prefer to be alone when overwhelmed ___I often don’t connect with people Determining Your Custom Remedy After completing the questionnaire, circle the remedy names where two or more checks appear to determine which remedies are needed. Try to limit the number of remedies to six or fewer by choosing only the ones that are needed. Ruth Mullikin Notes Eye Photo Tongue Photo Nail Photo pH Levels Sugars ________________ Urine pH ______________ Saliva pH ______________ Salts__________________ Cell Debris_____________ Nit Nit ________________ Amm Nit ______________ Total Ureas ____________ .7 5.4 7.2 40c 4m+ 2 5 6 Ruth Mullikin

 

Need help-SNH 510 – Case Studies in Natural Medicine

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: