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Quiz
Name
Name
First
First
Last
Last
Email
How long have you had your chronic condition?
Tell us why you would like our services?
In what ways is this condition affecting your quality of life?
Are you struggling with persistent pain or fatigue (or both)?
Yes
No
What kind of impact does your health have on your relationships, hobbies, studying or work?
Do you have a diagnosis for your chronic condition?
Yes
No
Which of the following programmes would you like to undertake?
--- Select ---
Personalised Treatment Programme - for chronic health conditions
Personalised Treatment Programme - for chronic pain conditions
Pain Mastery Programme (In-person group-format programme - 4 weeks)
Healing my chronic condition - Pilot Programme (Online hybrid course - 6 weeks)
Mindfulness-Based Stress Reduction Programme (Online self-guided course - 8 weeks)
Personalised Treatment Programme - preferred subscription duration
1 month
3 month
6 months
1 year
2 year
Lifetime
If you would like to undertake one of the Personalised Treatment Programmes, please indicate your prefered subscription duration.
Pre-existing medical conditions
Diabetes
Heart disease
Chest pains
Shortness of breath
Broken bones
Allergies
Heart murmur
Pneumonia
Epilepsy
Tachycardia
Oedema
Heart attack
Recent surgery
Palpitations
High blood pressure
Low blood pressure
Asthma
Seizures
Fainting
Additional Medical Info
Submit
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