Natural Wellness Consultants

Licensed Naturopaths - "Keeping you healthy naturally"

On line Consultation

 

"God made the earth yeild healing herbs which the prudent man should not neglect"  Ecclesiastes 38:4

We have provided this online consultation request form for the convenience of our friends and clients from around the globe who may not have naturopathic services readily available in their area. The fee for this service is $50.00 (USD).  Sorry, but we no longer use PayPal due to the frequent problems that we have had with that service. Here is how we work:  We provide useful, personalized, health information to you in good faith and we expect you to honor your obligation to pay for our services.  Once you have submitted your form, Please make your payment payable to: Bryan L. Fuller, ND and mail to: Bryan Fuller, ND, 12 Liberty Place, Hudson Falls, NY 12839 USA.   We only accept US domestic checks & money orders or International money orders payable in US Dollars.  Although we will endeavor to prepare your report ASAP, please allow sufficient time for a detailed evaluation of your information and the preparation of your report.  When we have received your payment in full and it has cleared our bank, we will forward your report to you. The content of your report is confidential and is intended for your personal educational and/or research purposes only. It should not be construed as medical advice and it has not been evaluated by the FDA and ins not intended to diagnose,treat or cure any disease. We assume no liability for your personal use or misuse of the information contained in your personal report, please consider all information provided appropriately.  It is entirely your personal decision whether or not you choose to incorporate any or all of the information presented into your health and wellness plan.

We are Traditional Naturopaths and Natural Health Consultants not Medical Doctors, we do not suggest that you discontinue any medications, treatments or therapies prescribed by your primary care physician without their prior approval or consent.

Please note that we will respond to a maximum of four (4) email follow-ups at no additional charge. Additional email follow-ups will be billed to you @ $2.50 (USD) each. By submitting your online consultation questionnaire you are indicating your acceptance of the terms mentioned above and that you wish to become a member of our private membership organization.  Forms containing incomplete contact information will not be processed!

NOTICE:  I am required by law to provide clients residing in the District of Columbia with the following statement:

I am a Registered Doctor of Naturopathy but I am not a licensed Medical Doctor and therefore do not practice “The application of scientific principles to prevent, diagnose or treat physical or mental diseases, disorders and conditions and to safeguard the life and health of any woman and infant through pregnancy and parturition.”

NOTE: Naturopathy takes a holistic approach to healing and wellness. What affects one part of the body, affects the whole body. Therefore, it is of the utmost importance that the information you provide on this form is as accurate and complete as possible.

If a check mark already appears inappropriately in any box, simply click on that box to clear it.

* Indicates required field



Please answer the following: *Demographic Information:
White
Black
Asian/Pacific Islander
Hispanic
Male
Female
Heterosexsual (straight)
Homosexual ( Gay or Lesbian)
Bisexual
Married
Single
Domestic partnership

*Please indicate all evironmental factors that apply:
My Home is less than 20 years old
I live in a mobile or modular home
Forced air heat
baseboard hot water heat
Solar heat
Electric heat
Wood stove or fireplace
Widow airconditioners
Central Airconditioning
I have a fresh air heat exchanger
My home is more than 40 years old
I use HEPA filters on my furnace
I have municipal water
I have an atersian well
I have a deep well
I have a shallow point driven well
I have to use a water softener
I drink only bottled water
I cook with only bottled water
I live near a railroad or industry
I work with toxic materials
I am exposed to lots of dust in my workplace
I live near or work with high tension power lines or radio/television transmitters
I use cell phones frequently
I frequently cook with aluminum utensils
I frequently drink from aluminum cans
I handle lead or cadmium batteries frequently
I handle fishing weights or ammunition
I'm exposed to mercury or eat canned tuna fish freqently
I am a smoker
I live with a smoker

*Personal and sexual health: Check all that apply
I have a monogamous sexual relationship
I have more than one sexual partner
I always have protected sex
I have frequent unprotected sex
I have had an STD
I have never had an STD
I have HIV or AIDS
I have been tested for HIV
I have not been tested for HIV
Females: PID or vaginal infections
Males: Prostate or other problems
Females: Hysterectomy or tubal ligation
Males: Vasectomy?
Frequent headaches
Dizzyness or fainting
High blood pressure
High blood sugar
Low blood sugar
Anemia
Sinus problems
Frequent ear infections
Vision problems
I wear corrective lenses or contacts
Liver disease
Daily alcohol usage
Occasional alcohol usage
I don't use alcohol
Past or present recreational drug usage
Kidney Problems
Pancreatic disease including Cystic Fibrosis
Rheumatoid Arthritis
Osteoarthritis (Degenerative Joint Disease)
Spinal (back or neck) problems
Smoker
Less than 1 pack per day
1-2 packs per day
Over 2 packs per day
Asthma, Lung or breathing problems
Erectile dysfunction (ED)
Vaginal pain or painful intercourse
Sleep disorders including insomnia
Digestive problems
Stomach ulcers or GERD
Painful hemorrhoids
Infrequent bowel movements (constipation)
1-3 bowel movements per day
Frequent diarrhea
Blood in stool
Frequent Urination
Blood in urine
Painful urination
Urinary incontinence
Dribbling after unrination
Irregular periods
Painful periods
Anal itching (no hemorrhoids)
Easily Fatigued/ low energy
Nerological problems
Neuromuscular disease
Heart problems
Heart attack
Angina
Frequent depression
Inability to concentrate or think clearly
ADD or ADHD
Joint pain
Frequent muscle aches
Enviromental allergies
Seasonal allergies
I bite my nails
Measels
Mumps
Chickenpox
Smallpox
Seasonal affective disorder (SAD)
If female: miscarriage
If female: Induced abortion
If male: circumscision
I have lived outside the USA or Canada
I travel outside the USA or Canada frequently
I excercise less than 3 times per week
allergic to dairy (lactose intolerance)
Ance, Eczema, Psoriasis
Blood Transfusion
*Personal or Family history of the following:
Asthma
Cancer
Drug or alcohol abuse
Diabetes
Emphysema (COPD)
Gout
Heart disease
Immune deficiency
Jaundice
Kidney disease
Liver disease
Mononucleosis
Mental illness
Neurological problems
Neuromuscular disease
Osteoporosis
Osteoarthritis (degenerative joint disease)
Parkinson's disease
Pancreatic disease including cystic fibrosis
Rheumatoid Arthritis
Senile dementia or Alzhiemers
Tuberculosis
Water retention (edema)
Please review your information then click the SUBMIT button below to send your on-line consultation form: