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If you have any questions about buying Practitioner products then email us at hello@purehealthvitamns.com or call us on +61410331331

Practitioner Health Questionnaire

Name

Age

Gender Male Female

Primary Health Complaint

Describe your symptoms,including frequency and duration

When did they start?

Is there any thing that them better or worse?

Is there a family history of these symptoms ?

Diet and Life style

How many hours do you sleep at night?

What is the quality of your sleep(out of 10,where 10 is best quality)

General stress levels(out of 10,where 10 is the highest)

Overall diet(out of 10,where 10 is the healthiest)

Do you smoke? If so,how many a day?

How many standard drinks do you consume per week?

How many times a week do you exercise?

What sort of exercise/activity do you do?

Please list any allergies you have.

Are you pregnant?

Are you breast feeding?

Medical Conditions:Do you have any of the following? Yes No

Medical History

Arthritis

Asthma

Chemical sensitivities

Coeliac disease

Diabetes

Epilepsy

Glaucoma

Heart Condition

High blood pressure

Inflammatory Bowel disease

Lactose in tolerance

Stomachulcers

Thyroid

Other Medical conditions-Give details:

Supplements

Other and/or referring practitioners you see and why?

Practitioner’sname

Phone number

E-mail address

Address

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Bonvit Psyllium Fibre Capsules

Bonvit Henna

BVPS600

As low as $17.33

Qty

- +

Psyllium husks come from the Psyllium seed, and provide a healthy, natural source of dietary fibre. Bonvit Psyllium Capsules help to maintain healthy cholesterol levels and can provide gentle relief from constipation. Bonvit Psyllium Capsules combine convenience with value for a busy lifestyle.

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Helps to promote a healthy digestive system
100 Percent natural dietary fibre source
Maintain healthy cholesterol levels
Provide gentle constipation relief

Psyllium Husk Powder 550mg.

Adults - Take 2-6 capsules once or twice daily followed by a full glass (250ml) of cool water. Swallow only one capsule at a time.

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