Anamnesis Questionnaire

In order to give you precise advice on your situation and your health, we would ask you to complete this questionnaire conscientiously and as completely and truthfully as possible. All diseases that have also been experienced and healed in the past should be noted.

Anamnesis Questionnaire.pdf

Please, email your completed questionnaire to soukupova@iscare.cz
or send it by fax 00420 234 770 295.