HOMEOPATHIC CASE TAKING FORM...

ABOUT HOMEOPATHIC CASE TAKING

Homeopathic case taking is the most essential part of the whole process of treating a patient. Case taking is a Science and also an Art. As per the basic principles of Classical Homeopathy ‘The person is treated as a whole and not just his disease’, this is the core of an individualized constitutional treatment. The very significance of the constitutional treatment in homeopathy is to heal the body-mind system from within. The constitutional treatment helps the body's own healing mechanism and enhances body's self-recovery capacity thus leading to a long-term cure.

The case-study hence is non-conventional, whereby various aspects of the patient's complaints (Physical and Mental), lifestyle, personality, food habits, emotional make-up, personal and the family history, etc are evaluated appropriately to decide on the correct medication to treat the disease. Thus, the entire constitution (physical and mental) of the patient is evaluated in a systematic and scientific manner.


Incomplete information will make correct choice difficult. You are, therefore, requested to supply all information without keeping back anything as irrelevant or of little importance. The information you supply forms the basis of further enquiry designed to assist you in the further delineation of the problem. Full co-operation, therefore, is requested. If we find that the information given is insufficient for instituting treatment or it requires further detailed processing of information and study of your Case, we will send you few more specific questions to be answered by you.  
 

All information shared by you is, of course, strictly confidential.
 

P.S.

We try to maintain a standardized Case Record, to facilitate that, you are requested to write in the following way.

Write in the way the history is printed.
If you download the questionnaire, you may write your answers below the respective questions.

Leave margin of 1" at the top in front, and at the bottom on the back.

 

 

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1. CHIEF COMPLAINTS
Describe fully what bothers you most. Each trouble should be detailed as under:

[You may grade the symptoms to stress on its intensity: 5 – Maximum, 1 – Minimum e.g. Headache (5), tingling sensation (2), etc.]
 

a. Area affected: Location, extension, direction of spread, the march of events.


b. Sensation experienced in the area of trouble.

 

c. Conditions that have brought on the trouble:  Examine the circumstances that occurred before or at the time of onset, paying attention to physical as well as emotional factors.

 

d. Conditions that increase the trouble or those which afford relief.

 

e. Other troubles experienced at the same time along with the main trouble, for example...perspiration/nausea /vomiting /gas/with pains.

 

2. OTHER COMPLAINTS
If you have any other complaints describe them here. Each should be described fully as suggested above under numerically defined headings for the Chief Complaint under the different headings .

                                                                                                                      
3. PREVIOUS ILLNESS
Give a detailed description of the various illnesses you have had in the past, which may/may not have a bearing on the present condition. Also describe the type of treatment taken and the response of these illnesses to medication.
 

4. FAMILY HISTORY
Details concerning the health and diseases (if any) that appear to recur in other family members like Grand parents, Parents, Uncles, Brothers and Sisters. Also give details concerning the health of spouse and children.
Details of each family member should be under the following headings: Family Member, Relation with you, Age, Health Status / Illness suffered

 

5. PERSONAL DATA

Physical Description

Height: 

Weight:                                              
Complexion: 
Body Type (Slim/Average/Heavy): 
Physical Challenge if any:
Ethnic origin:

 

6. PHYSICALS
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