info@clairesambolino.com

Resources

Please download and complete a questionnaire in preparation for your appointment by clicking on the links below. The questionnaire is available in English or Italian.  NB. Please download and save before filling in the editable form otherwise your entries may be lost.

It is kindly requested that questionnaires be returned 48 hours before your consultation so that your health concerns can be carefully studied, and your food diary analysed.

It is recommended that personal data be emailed or sent using secure post or encrypted email to protect privacy.

Terms of Agreement

All clients will need to sign the Terms of Agreements and return before your first consultation. These can be downloaded here.

Privacy

I respect your privacy and am committed to protecting it. Sensitive personal data is collected and used in strict accordance with the new European data protection law; General Data Protection Regulation (GDPR). A copy of my privacy policy can be downloaded here. By using my services you are agreeing to this policy.

3 Day Food Diary

The food diary is incorporated in the Health Questionnaire. For clients wishing to complete an additional diary for review at subsequent consultations please download here. NB. Please download and save before compiling.

In English

In Italian

Symptoms Tracker

A weekly symptoms trackers is available for clients wishing to monitor their progress.

In English

In Italian