Client/Patient Assessment Form


  1. On a sheet of unlined paper please hand-write a full page about your health condition.
  2. Make a health time-line listing all the significant health events in your life from conception to the present (e.g. major illnesses, major injuries, traumatic incidents, serious conflicts with people in your life, any resulting complications from these incidents, etc.)

Bring both of these with you to the first interview.

Contact me using this form or call me to schedule an appointment.

Roger Barr
+1 (559)900-2991, +52 (222) 739-8334 (cell & WhatsApp)
roger {a.t} canhealyourself {d.t} comĀ  (email & Facetime)
Skype: rrandor

By Appointment Only