Caraf Avnayt's Herbal Energy Medicine Order Form

STEP 1 - REQUIRED INFORMATION




















Listing any clinically diagnosed problems, please mention how long you have been experiencing the condition/s and/or symptoms caused by it. We treat the entire energy field, not just one or two problems so feel free to list all the health problems you are facing.



STEP 2 - OPTIONAL INFORMATION If you would rather place your order in the queue first and send us this information by email in the next 2 days, please click the button below to move on to the next step.

All the following questions are optional, but the more information you give us, the easier it is for us to map out your energy field and prepare your treatment.


Is this pain part of a diagnosed condition or injury? If so, please mention which causes you the most pain. How long have you had the pain for? What have you noticed lessens the pain, and what causes it to increase?



Please include anything you feel had an effect in bettering or worsening your condition.




Color, Thick/Thin, Smooth/Coarse, Strength and Sensitivity




How long do you usually sleep for? When do you naturally fall asleep? If you have been having sleeping problems, tell us when it started and what you think stops you from sleeping well.




The climate and weather patterns of the place you are living in deeply affect your energy field. The information you give me here helps me understand your energy field's basic comfort structure and helps me narrow down my list of natural energies that suit you.








(For example: My feet have been slightly swollen for a few years now. My feet are very sensitive to cold and heat. I'm most comfortable in sneakers or sandals though I have to wear heels at work.)




(For example: I have no knee problems usually, but I feel a little clicking when I climb down stairs too fast.)




(For example: I catch colds and infections all the time but rarely fall so ill I have to stay home for the whole day.)




(How quickly can you develop allergies, how do you react to pollens, how much pollution are you regularly exposed to, and how do you react? For example; I cannot handle dust and get small swollen lumps on my hands or face when I'm gardening. I cannot handle smoke either.)




(For example: I only let myself go in my bedroom though I have inner fireworks all the day through - I'm really really sensitive.)




(For example: I like the tastes that are sweet, but not overly so. I love apples most of all.)




(For example: I usually drink a few glasses of water a day though that gets down to half when I am traveling or out of the office on field work.)




When do you have the most energy in the day? When do you have the least energy? What foods/activities/people energize you? What foods/activities/people drain you?




mentioning pollutants and pollution levels, access to nature spaces, and your comfort level with your environment;




mentioning pollutants and pollution levels, access to nature spaces, and your comfort level with your environment;




(Smoking/Long Term Medication/Alcohol/Narcotics etc)