Pain Questionnaire

Pain Questionnaire

Posted on by Holistic Harmony

QUESTIONNAIRE ON YOUR EXPERIENCE USING THE TECHNIQUES FOR REDUCTION AND «FREEDOM FROM PAIN AND ENHANCING INNER HEALING POWER»

 

NAME _______________________________ SEX ___________ AGE _______

COUNTRY ___________________________ PROFESSION ___________________

Email ___________________________________

 

Physical problem / pain/ discomfort ________________________________________

_________________________________________________________________

__________________________________________________________________

Where do you experience How long have you been pain or discomfort? experiencing this pain or discomfort?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Once you have filled out at least a portion of this questionaire, please copy and past it into an email and send it to

webmaster@holisticharmony.com

RESULTS OF EMPLOYING THE TECHNIQUES  

 

1. Date ________ time ______ Where did you employ it? ____________________

I employed technique NΤ. 2__ Breathing, NΤ. 3__ Relaxation, NΤ.4___ EFT

For the following pain / problem /discomfort __________________________________

I rated the initial pain (from 0 to 10) at ____ before the technique and___ after the technique.

I employed the technique for ______ minutes for ____ times.

Did the problem / pain / discomfort return. ___ No ____ Yes.

If yes after how many hours? _______

Comments _______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

 

2. Date ________ time ______ Where did you employ it? ____________________

I employed technique NΤ. 2__ Breathing, NΤ. 3__ Relaxation, NΤ.4___ EFT

For the following pain / problem /discomfort __________________________________

I rated the initial pain (from 0 to 10) at ____ before the technique and___ after the technique.

I employed the technique for ______ minutes for ____ times.

Did the problem / pain / discomfort return. ___ No ____ Yes. If yes after how many hours? _______

Comments _______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

 

3. Date ________ time ______ Where did you employ it? ____________________

I employed technique NΤ. 2__ Breathing, NΤ. 3__ Relaxation, NΤ.4___ EFT

For the following pain / problem /discomfort __________________________________

I rated the initial pain (from 0 to 10) at ____ before the technique and___ after the technique.

I employed the technique for ______ minutes for ____ times.

Did the problem / pain / discomfort return. ___ No ____ Yes. If yes after how many hours? _______

Comments _______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

 

4. Date ________ time ______ Where did you employ it? ____________________

I employed technique NΤ. 2__ Breathing, NΤ. 3__ Relaxation, NΤ.4___ EFT

For the following pain / problem /discomfort __________________________________

I rated the initial pain (from 0 to 10) at ____ before the technique and___ after the technique.

I employed the technique for ______ minutes for ____ times.

Did the problem / pain / discomfort return. ___ No ____ Yes. If yes after how many hours? _______

Comments _______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

 

5. Date ________ time ______ Where did you employ it? ____________________

I employed technique NΤ. 2__ Breathing, NΤ. 3__ Relaxation, NΤ.4___ EFT

For the following pain / problem /discomfort __________________________________

I rated the initial pain (from 0 to 10) at ____ before the technique and___ after the technique.

I employed the technique for ______ minutes for ____ times.

Did the problem / pain / discomfort return. ___ No ____ Yes. If yes after how many hours? _______

Comments _______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

 

6. Date ________ time ______ Where did you employ it? ____________________

I employed technique NΤ. 2__ Breathing, NΤ. 3__ Relaxation, NΤ.4___ EFT

For the following pain / problem /discomfort __________________________________

I rated the initial pain (from 0 to 10) at ____ before the technique and___ after the technique.

I employed the technique for ______ minutes for ____ times.

Did the problem / pain / discomfort return. ___ No ____ Yes. If yes after how many hours? _______

Comments _______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

 

7. Date ________ time ______ Where did you employ it? ____________________

I employed technique NΤ. 2__ Breathing, NΤ. 3__ Relaxation, NΤ.4___ EFT

For the following pain / problem /discomfort __________________________________

I rated the initial pain (from 0 to 10) at ____ before the technique and___ after the technique.

I employed the technique for ______ minutes for ____ times.

Did the problem / pain / discomfort return. ___ No ____ Yes. If yes after how many hours? _______

Comments _______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

 

8. Date ________ time ______ Where did you employ it? ____________________

I employed technique NΤ. 2__ Breathing, NΤ. 3__ Relaxation, NΤ.4___ EFT

For the following pain / problem /discomfort __________________________________

I rated the initial pain (from 0 to 10) at ____ before the technique and___ after the technique.

I employed the technique for ______ minutes for ____ times.

Did the problem / pain / discomfort return. ___ No ____ Yes. If yes after how many hours? _______

Comments _______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

9. Date ________ time ______ Where did you employ it? ____________________

I employed technique NΤ. 2__ Breathing, NΤ. 3__ Relaxation, NΤ.4___ EFT

For the following pain / problem /discomfort __________________________________

I rated the initial pain (from 0 to 10) at ____ before the technique and___ after the technique.

I employed the technique for ______ minutes for ____ times.

Did the problem / pain / discomfort return. ___ No ____ Yes. If yes after how many hours? _______

Comments _______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

10. Date ________ time ______ Where did you employ it? ____________________

I employed technique NΤ. 2__ Breathing, NΤ. 3__ Relaxation, NΤ.4___ EFT

For the following pain / problem /discomfort __________________________________

I rated the initial pain (from 0 to 10) at ____ before the technique and___ after the technique.

I employed the technique for ______ minutes for ____ times.

Did the problem / pain / discomfort return. ___ No ____ Yes. If yes after how many hours? _______

Comments _______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

 

11. Date ________ time ______ Where did you employ it? ____________________

I employed technique NΤ. 2__ Breathing, NΤ. 3__ Relaxation, NΤ.4___ EFT

For the following pain / problem /discomfort __________________________________

I rated the initial pain (from 0 to 10) at ____ before the technique and___ after the technique.

I employed the technique for ______ minutes for ____ times.

Did the problem / pain / discomfort return. ___ No ____ Yes. If yes after how many hours? _______

Comments _______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

 

12. Date ________ time ______ Where did you employ it? ____________________

I employed technique NΤ. 2__ Breathing, NΤ. 3__ Relaxation, NΤ.4___ EFT

For the following pain / problem /discomfort __________________________________

I rated the initial pain (from 0 to 10) at ____ before the technique and___ after the technique.

I employed the technique for ______ minutes for ____ times.

Did the problem / pain / discomfort return. ___ No ____ Yes. If yes after how many hours? _______

Comments _______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

Hello world!

Hello world!

Posted on by Holistic Harmony

Welcome to WordPress. This is your first post. Edit or delete it, then start blogging!

 

Elements

Posted by  on September 5, 2008Comments Off

 

The purpose of this HTML is to help determine what default settings are with CSS and to make sure that all possible HTML Elements are included in this HTML so as to not miss any possible Elements when designing a site.

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Heading 4

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Paragraph

Lorem ipsum dolor sit amet, test link adipiscing elit. Nullam dignissim convallis est. Quisque aliquam. Donec faucibus. Nunc iaculis suscipit dui. Nam sit amet sem. Aliquam libero nisi, imperdiet at, tincidunt nec, gravida vehicula, nisl. Praesent mattis, massa quis luctus fermentum, turpis mi volutpat justo, eu volutpat enim diam eget metus. Maecenas ornare tortor. Donec sed tellus eget sapien fringilla nonummy. Mauris a ante. Suspendisse quam sem, consequat at, commodo vitae, feugiat in, nunc. Morbi imperdiet augue quis tellus.

Lorem ipsum dolor sit amet, emphasis consectetuer adipiscing elit. Nullam dignissim convallis est. Quisque aliquam. Donec faucibus. Nunc iaculis suscipit dui. Nam sit amet sem. Aliquam libero nisi, imperdiet at, tincidunt nec, gravida vehicula, nisl. Praesent mattis, massa quis luctus fermentum, turpis mi volutpat justo, eu volutpat enim diam eget metus. Maecenas ornare tortor. Donec sed tellus eget sapien fringilla nonummy. Mauris a ante. Suspendisse quam sem, consequat at, commodo vitae, feugiat in, nunc. Morbi imperdiet augue quis tellus.

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List Types

Definition List

Definition List Title
This is a definition list division.

Ordered List

  1. List Item 1
  2. List Item 2
  3. List Item 3

Unordered List

  • List Item 1
  • List Item 2
  • List Item 3

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Forms

Legend

Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Nullam dignissim convallis est. Quisque aliquam. Donec faucibus. Nunc iaculis suscipit dui. Nam sit amet sem. Aliquam libero nisi, imperdiet at, tincidunt nec, gravida vehicula, nisl. Praesent mattis, massa quis luctus fermentum, turpis mi volutpat justo, eu volutpat enim diam eget metus.

Form Element

Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Nullam dignissim convallis est. Quisque aliquam. Donec faucibus. Nunc iaculis suscipit dui.


 

 Radio 1
 

 Radio 2
 

 Radio 3
 

 Radio 1
 

 Radio 2
 

 Radio 3
 

 

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Tables

Table Header 1 Table Header 2 Table Header 3
Division 1 Division 2 Division 3
Division 1 Division 2 Division 3
Division 1 Division 2 Division 3

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Misc Stuff – abbr, acronym, pre, code, sub, sup, etc.

Lorem superscript dolor subscript amet, consectetuer adipiscing elit. Nullam dignissim convallis est. Quisque aliquam. cite. Nunc iaculis suscipit dui. Nam sit amet sem. Aliquam libero nisi, imperdiet at, tincidunt nec, gravida vehicula, nisl. Praesent mattis, massa quis luctus fermentum, turpis mi volutpat justo, eu volutpat enim diam eget metus. Maecenas ornare tortor. Donec sed tellus eget sapien fringilla nonummy. NBAMauris a ante. Suspendisse quam sem, consequat at, commodo vitae, feugiat in, nunc. Morbi imperdiet augue quis tellus. AVE

Lorem ipsum dolor sit amet,
 consectetuer adipiscing elit.
 Nullam dignissim convallis est.
 Quisque aliquam. Donec faucibus.
Nunc iaculis suscipit dui.
Nam sit amet sem.
Aliquam libero nisi, imperdiet at,
 tincidunt nec, gravida vehicula,
 nisl.
Praesent mattis, massa quis
luctus fermentum, turpis mi
volutpat justo, eu volutpat
enim diam eget metus.
Maecenas ornare tortor.
Donec sed tellus eget sapien
 fringilla nonummy.
NBA
Mauris a ante. Suspendisse
 quam sem, consequat at,
commodo vitae, feugiat in,
nunc. Morbi imperdiet augue
 quis tellus.
AVE

“This stylesheet is going to help so freaking much.”
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Let’s start with an unordered list:

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And then move on to a more interesting ordered list:

  1. one, two
    1. buckle my shoe
  2. three, four
    1. knock at the door
  3. Five, six
    1. pick up sticks
  4. Seven, eight, lay them straight
    1. Nine, ten, a big fat hen
    2. Eleven, twelve, dig and delve
    3. Thirteen, fourteen, maids a’courting
    4. Fifteen, sixteen, maids in the kitchen
    5. Seventeen, eighteen, maids a’waiting
    6. Nineteen, twenty, my platter’s empty …