Please download and complete a questionnaire before making an appointment by clicking on the images below. The questionnaire is available in English or Italian. When filling in the editable version, please download and save before filling in otherwise your entries may be lost.

It is kindly requested that questionnaires be returned at least 3 days before your consultation so that your specific health concerns and medications can be carefully studied.

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.


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 Health Questionnaire has a 3-day food diary included however for clients wishing to complete an additional diary for review at follow-up visits please download here.