Medical Herbalism: The Science and Practice of Herbal Medicine
|
|
- Neal Jefferson
- 6 years ago
- Views:
Transcription
1 Medical Herbalism: The Science and Practice of Herbal Medicine Hoffmann, David ISBN-13: Table of Contents Introduction Part One: Introduction to Principles and Practices 1--Herbs, Holism, and Science Science and Phytotherapy Pharmacognosy and Ways to Assess Herb Quality The Conservation of Medicinal Plants 2--Classification of Medicinal Plants The Linnaean System of Classification Derivation of Botanical Names 3--An Introduction to Phytochemistry Primary and Secondary Plant Metabolites Commonly Used Terms and Concepts 4--Carbohydrates Monosaccharides Polysaccharides Glycoproteins Glycosides Gums and Mucilages 5--Lipids Fatty Acids Lipids Containing Glycerol 6--Terpenes Monoterpenes Iridoids Sesquiterpenes Sesquiterpene Lactones Diterpenoids Saponins Triterpenoid Saponins Cardenolides and Bufadienolides Phytosterols Nortriterpenoids Plant Exudates Resins Oleoresins Balsams Gum Resins 7--Polyphenols Simple Phenols and Phenolic Acids Phenylpropanoids and Cinnamic Acids Coumarins Quinones Xanthones Stilbenoids Flavonoids Flavones and Flavonols Isoflavonoids Flavanones Dihydrochalcones Biflavonoids
2 Lignans and Neolignans Tannins 8--Alkaloids Pyrrolidine and Piperidine Alkaloids Tropane Alkaloids Pyrrolizidine Alkaloids Purine Alkaloids Isoquinoline Alkaloids Indole Alkaloids Ergot Alkaloids Carboline Alkaloids Quinoline Alkaloids Quinolizidine Alkaloids Diterpenoid Alkaloids Steroid Alkaloids Miscellaneous Alkaloids 9--Pharmacology Pharmacodynamics Phytoestrogens Pharmacokinetics Immunomodulators Inflammation and Anti-Inflammatory Agents Cancer and Plant Constituents Antiviral Agents Antioxidants and Free Radical Scavengers Cardiac Glycosides Nonsteroidal Cardioactive Plant Constituents Cholesterol and Lipid-Lowering Activity Hypertension and Hypotensive Agents Platelet Function and Cardiovascular Herbs and the Liver Hypoglycemic Agents 10--Toxicity, Contraindications, and Safety Evaluating Causality in Adverse Events Toxicology Oxalic Acid Terpenes Glycosides Polyphenolics Alkaloids Polypeptides Lectins Photosensitivity 11--The Formulation and Preparation of Herbal Medicines Herbal Medicines Infusions Decoctions Tinctures (Tincturae) Fluid Extracts (Fluid Extracta) Syrups, Elixirs, and Emulsions (Emulsiones) Juices (Succi), Linctuses (Lincti), Mucilages and Oxymels Waters (Aqua) Capsules, Pills, and Tablets Lozenges (Trochisci) and Pastilles (Pastilli) Baths (Balneotherapy) Douches and Enemas Ointments and Suppositories Liniments Gargles (Gargarisma) and Mouthwashes Inhalants (Vapors) and Spray Solutions (Nebulae) Oils Compresses and Poultices Incompatibility Part Two: Treatment Approaches by Body System 12--A Model of Holistic Herbal Medicine
3 Phytotherapeutic Selection Criteria Dosage and Formulation Criteria Outline of Treatment Chapters 13--The Digestive System Flatulence Constipation Laxatives Diarrhea Aphthous Ulcers Periodontal Disease Esophagitis and Gastroesophageal Reflux Gastritis Peptic Ulcers Hiatus Hernia Functional Dyspepsia or â œindigestionâ Irritable Bowel Syndrome Inflammatory Bowel Disease Ulcerative Colitis Diverticulitis Jaundice Chronic Hepatitis Viral Hepatitis Cirrhosis Cholecystitis Cholelithiasis Hemorrhoids 14--The Cardiovascular System Tonics for the Cardiovascular System Cholesterol Hypertension Arteriosclerosis Congestive Heart Failure Angina Pectoris Peripheral Arterial Occlusive Disease Varicose Veins 15--The Respiratory System Coughs Acute Bronchitis Chronic Bronchitis Pertussis Asthma Emphysema The Common Cold Influenza Hay Fever Sinusitis Laryngitis Tonsillitis 16--The Nervous System Managing Stress: An Overview Depression Insomnia Withdrawal from Benzodiazepines Anorexia Nervosa Headache Migraine Neuritis Tinnitus Motion Sickness Shingles 17--The Urinary System Frequency Dysuria Hematuria Edema Cystitis
4 Urinary Calculus 18--The Reproductive System Emmenagogues Amenorrhea Dysmenorrhea Premenstrual Syndrome Menopause Pregnancy Herbs to Avoid During Pregnancy Uterine Fibroids Endometriosis Fibrocystic Breast Disease Benign Prostatic Hypertrophy 19--The Musculoskeletal System External Applications for Musculoskeletal Problems Myalgia Osteoarthritis Rheumatoid Arthritis Osteoporosis Gout Bursitis and Tendinitis Restless Leg Syndrome 20--The Skin Herbs for Topical Application Eczema and Dermatitis Psoriasis Acne 21--The Immune System General Support Protocols Detoxification Postoperative Recovery General Guidelines for Treating Infection Vaginitis Prostatitis Boils Fungal Skin Infection Cancer 22--The Endocrine System Hypothyroidism Hyperthyroidism Diabetes Mellitus The Adrenal Glands 23--Phytotherapy and the Elderly Toning and Nurturing Health in Elders Prevention and Treatment of Disease in Elders 24--Phytotherapy and Children Measles Mumps Colic Constipation Diarrhea Indigestion Nausea Otitis Media Attention Deficit Disorder Diaper Rash Cradle Cap Impetigo 25--Herbal Actions Adaptogen Alterative Anticatarrhal Anti-Inflammatory
5 Antimicrobial Antirheumatic Antispasmodic Astringent Bitter Cardiac Remedies Carminative Cholagogue Demulcent Diuretic Emmenagogue Expectorant Hepatic Hypnotic Hypotensive Nervine Stimulant 26--Materia Medica Appendices 1--Glossary 2--Selected Examples of Binomial Meanings 3--Herbs by Latin and Common Names 4--Pharmacy Terms 5--Weight and Measure Conversion 6--Herbal Information Sources 7--Taxonomy Hierarchy Bibliography Index
EVIDENCE-BASED VITAMIN AND MINERAL USAGE SUMMARY TABLE (APRIL 2002)
Acne Acrodermatitis Enteropathica Adrenal Support Age Related Cognitive Decline Alcoholism/Alcohol Withdrawal Alzheimer's Disease Amenorrhoea Anaemia Angina Anorexia Nervosa Anxiety Asthma Atherosclerosis
More informationUNIT 1: INTRODUCTION AND HERBAL REVIEW
INTERMEDIATE HERBAL COURSE OUTLINE UNIT 1: INTRODUCTION AND HERBAL REVIEW Lesson 1: Let s Get Started! Lesson 2: Introduction to the Intermediate Course Why Choose Herbs? An Ecological Relationship How
More informationPharmacy Prep. Qualifying Pharmacy Review
Pharmacy Prep 2014 Misbah Biabani, Ph.D Director, Tips Review Centres 5460 Yonge St. Suites 209 & 210 Toronto ON M2N 6K7, Canada Luay Petros, R.Ph Pharmacy Manager, Wal-Mart, Canada 1 Disclaimer Your use
More informationNatural Balance strives to offer efficacious, holistic, natural health-care, in a personalized, caring and supportive manner.
- What do you do at Natural Balance? - What do you treat? - Do you treat children? - Why use a Herbalist? - How fast do these remedies take to work? - Can I take these remedies with these pharmaceutical
More informationLiver Health: Do you have liver problems? Yes No If so, please specify:
Medical History General Last Name: First Name: Date of Birth: Age: Contact Number: Are you in good health to the best of your knowledge Medical Information: Please list any physicians you see and their
More informationTABLE OF CONTENTS INTRODUCTION DIGESTION SUGAR HANDLING MUSCULOSKELETAL. Introduction I
INTRODUCTION TABLE OF CONTENTS Introduction I DIGESTION Acid Indigestion D1 Excessive Appetite D9 Reduced Appetite D13 Biliary Insufficiency D19 Colitis D27 Constipation D33 Dry Mouth D39 Dysbiosis D43
More informationMedical History Form
Medical History Form Full Name Title: Mr/Mrs/Ms/Miss Address Date of Birth Date Telephone: Mobile: Email: How did you hear about the Garden of health? G.P s Name and Address Are you currently seeing your
More informationClinical Herbal Medicine
SUBJECT OUTLINE Subject Name: Clinical Herbal Medicine SECTION 1 GENERAL INFORMATION Subject Code: WHMC311 Award/s: Total course credit points: Level: Bachelor of Health Science (Naturopathy) 128 3 rd
More informationUNIT 1: HERBAL BASICS
INTRODUCTORY HERBAL COURSE OUTLINE UNIT 1: HERBAL BASICS Lesson 1: The Herbal Approach and World Healing Traditions Introduction to the Course Why Herbs? Western Herbalism Chinese Medicine Ayurveda Herbal
More informationInitial Consultation
Today s Date: Initial Consultation Thank you for choosing Apollo Health and Wellness. Please take your time to fill out this form. It will help us to concentrate on areas of your health that need attention
More informationPremium Specialty: Pediatrics
Premium Specialty: Pediatrics Credentialed Specialties include: Adolescent Medicine, Pediatric Adolescent, and Pediatrics This document is designed to be used in conjunction with the UnitedHealth Premium
More informationFamily Naturopathic Clinic
Mark Orbay, B.Sc., N.D. Doctor of Naturopathic Medicine 265 Carling Avenue, Suite 610 Tel: (613) 230-6100 Fax: (613) 230-0070 Name: Phone (Home) Address: (Office) Date of Birth: / / Age: (Month) (Day)
More informationBACK TO BASICS HEALTH & NUTRITION COMPREHENSIVE HEALTH HISTORY
BACK TO BASICS HEALTH & NUTRITION COMPREHENSIVE HEALTH HISTORY Thank you for choosing Back To Basics Health & Nutrition to assist you with your natural health care. The ability to draw effective conclusions
More information6 Healing Flowers & Herbs
-Arnica -Calendula -Yarrow -Rose hips -Chamomile -Thyme Keith Jenkins, Owner/CMT #59131 (619)-204-5967 Arnica (Arnica montana) -High altitude growing flower and member of the daisy family. Anti-inflammatory,
More informationHow much do you know about illnesses or health problems for your parents, grandparents, brothers, sisters, and/or children? 1 A lot Some None at all
Family Health History Please answer each question as honestly as possible. There are no right or wrong answers to nay of the questions. It is important that you answer as many questions as you can. We
More informationAdult Health History
Patient Name Date of Birth Adult Health History This form will assist us in obtaining a complete medical history and health record on you. By completing this ahead of time it will also simply your visit
More informationREFLEXOLOGY HEALTH RECORD
REFLEXOLOGY HEALTH RECORD THIS FORM IS TO BE COMPLETED BY THE CLIENT FIRST THEN BY PRACTITIONER FOR INITIAL SESSION Client Date of Birth Telephone Home Business Ext Email Address Street # City Street Name
More informationPharmacotherapy Handbook
Pharmacotherapy Handbook Eighth Edition Barbara G. Wells, PharmD, HP, FCCP, BCPP Dean and Professor Executive Director, Research Institute of Pharmaceutical Sciences School of Pharmacy, The University
More informationHolistic Massage Diploma Assessment Book
Holistic Massage Diploma Assessment Book # Contents Contents... 2 Study Tips & Suggestions... 3 Assessment Questions... 5 The Application of Massage... 5 Contraindications & Cautions... 7 The Need for
More informationABUNDANT HEALTH CHIROPRACTIC New Patient Form PERSONAL INFORMATION. Name: Gender: M F Today's Date: / / Birth Date: / / Age: Social Security #: - -
ABUNDANT HEALTH CHIROPRACTIC New Patient Form PERSONAL INFORMATION Name: Gender: M F Today's Date: / / Birth Date: / / Age: Social Security : - - Home Address: City, State, Zip: Home Phone: ( ) Work Phone:
More informationAnatomy, Physiology, & Disease 3rd Edition, 2016
A Correlation of Anatomy, Physiology, & Disease 3rd Edition, 2016 To the Mississippi Curriculum Framework Health Sciences Core II 2008 CTE Health Sciences Frameworks Table of Contents Unit 6: Vital Organs
More informationRonald Steriti, ND, PhD 1284 Granada Blvd Naples, FL (239)
Ronald Steriti, ND, PhD 1284 Granada Blvd Naples, FL 34102 (239) 659-2684 ron@naturdoctor.com www.naturdoctor.com Finding the Cause of Disease with Specialty Lab Tests Finding the Cause of Disease with
More informationIn your own words, please write the reason you are here. Please be specific, putting in dates as necessary. Use the back of the form if needed.
Name: SS# In your own words, please write the reason you are here. Please be specific, putting in dates as necessary. Use the back of the form if needed. Patient Medical, Surgical and Family History Review
More informationUNIT 1: HERBAL BASICS
INTRODUCTORY HERBAL COURSE OUTLINE UNIT 1: HERBAL BASICS Lesson 1: The Herbal Approach and World Healing Traditions Introduction to the Course Why Herbs? European Herbalism Traditional Chinese Medicine
More informationMedical History Form
General: Medical History Form 1. Chief Complaint: What are the main health concerns you wish to address? 2. Current and Past Treatment: Have you received treatment for these problems? Yes No, if yes, which:
More informationJ. B. Chapman Dr. Schussler's Biochemistry
J. B. Chapman Dr. Schussler's Biochemistry Reading excerpt Dr. Schussler's Biochemistry of J. B. Chapman Publisher: B. Jain http://www.narayana-verlag.com/b1476 In the Narayana webshop you can find all
More informationNorthern Monmouth County Medical Associates
Northern Monmouth County Medical Associates 195 Route 9; Suite 112 Manalapan, NJ 07726 (732)345-2070 FAX: (732) 345-2072 DATE: COMPLETE MEDICAL HISTORY FORM NAME: AGE: DATE OF BIRTH: I. CHIEF COMPLAINT:
More informationEvolve180 / Ideal Northwest Health Profile
Evolve180 / Ideal Northwest Health Profile ABOUT YOU First Name: Last Name: Address: City: State: Zip: Phone: Email: Date of Birth: Age: Height: Occupation: How did you find out about our program? Marital
More informationBASIL ESSENTAIL OIL. Botanical Name: Ocimum basilicum. Common Method of Extraction: Steam Distilled. Part Typically Used: Leaves and Flowers/Buds
BASIL ESSENTAIL OIL Botanical Name: Ocimum basilicum Common Method of Extraction: Steam Distilled Part Typically Used: Leaves and Flowers/Buds Color: Clear Consistency: Thin Perfumery Note: Top Strength
More informationWebinar 3. Natures Aid: Herbals
Webinar 3 Natures Aid: Herbals Aloe Vera What Is It Good For? 1. Digestion 2. Detoxification 3. Circulation 4. Joint Health 5. Skin Care 6. Immune Health How Does It Help? Contains a vast array of nutrients
More informationPLEASE COMPLETE ALL SECTIONS OF THIS FORM
PLEASE COMPLETE ALL SECTIONS OF THIS FORM Patient Name: Date of Birth: Referring Doctor? (Name, telephone number and address) Chief Complaint: Why have you come here? How did it start? What are the symptoms?
More informationApple Cider Vinegar Research has shown Apple Cider Vinegar cure high cholesterol, diabetes, sore throats and heart burn.
Home Remedies Winter home remedy drink What you need: Ginger juice one cup Lemon Juice one cup Garlic Juice one cup Apple cider Vinegar one cup How to make: Crush ginger and garlic separately Squeeze to
More informationNew Patient Form. Patient Demographics. Emergency Information. Employment Information. Page 1 of 7. Family Health Chiropractic Care
Page 1 of 7 Patient Demographics First Name* Last Name* Date Of Birth* Home Phone* Mobile Phone Phone Gender* Email Preferred Communication Street Address 1* Street Addresss 2 Zip* City* State* Emergency
More informationClinical Nutritional Medicine
SUBJECT OUTLINE Subject Name: Clinical Nutritional Medicine SECTION 1 GENERAL INFORMATION Subject Code: NMDC221 Award/s: Total course credit points: Level: Bachelor of Health Science (Naturopathy) 128
More informationPersonal Health Profile. Address:
1 P age Personal Health Profile Initials: Personal Health Profile Name: Address: Date: Phone Numbers: Home: Work: Fax: E- mail: Date of Birth: Age: Weight: Height: Blood Type: Occupation: Relationship
More informationBREAKTHROUGH MEDICINE
Page1 BREAKTHROUGH MEDICINE SHAIDA SINA, NMD PRACTICE Patient Visit LOCATION: Location: 2530 W. ST. RT. 89A, Suite B1 Core Chiropractic Sedona, AZ 86336 2530 W. SR 89A VIRTUAL Sedona, AZ OFFICE: 86336
More informationNew Patient Intake Form Pickering Chiropractic Health Centre 1154 Kingston Road Pickering ON, L1V 1B4
New Patient Intake Form Pickering Chiropractic Health Centre 1154 Kingston Road Pickering ON, L1V 1B4 Date: Name Age Date of Birth Address Postal Code Occupation Phone (home) (work) Okay to leave a message?
More informationFRANKINCENSE essential oil
FRANKINCENSE Frankincense Boswellia carterii Boswellia frereana Boswellia sacra analgesic, anti-aging, antibacterial, anticatarrhal, antidepressant, antifungal, anti-inflammatory, antimicrobial, antioxidant,
More informationESSENTIAL OILS USES CHART
ESSENTIAL OILS USES CHART Basil OIL PROPERTIES BENEFITS/USES HOW TO USE PRECAUTIONS Spicy Concentration Avoid with pregnancy Warm PMS Herbal Boost immunity Bergamot Soothing Vermifuge Antibiotic Deodorant
More informationCERTIFIED ADVANCED HERBALISM COURSE - SESSION 9: Herbs & Plants V
CERTIFIED ADVANCED HERBALISM COURSE - SESSION 9: Herbs & Plants V LAVENDER (Lavandula Vera) LEEK (Allium Ampeloprasum Porrum) LEMON (Citrus Limon) LEMON BALM (Melissa Officinalis) LIME TREE (Tilia x Vulgaris)
More informationUnit 13 Grandma s Remedies
Topics: Getting familiar with herbal/traditional Examining a patient. Giving diagnosis and advice for treatment. Objective: Use expressions and vocabulary related to traditioanl medicine orally and in
More informationColon Hydrotherapy Questionnaire
Colon Hydrotherapy Questionnaire Full Name: Address: Telephone: Occupation: How did you hear about us? Email: Date of Birth: Please list any conditions for which you are currently being treated: Women
More informationPatient Admittance Form
Patient Admittance Form Mah Chiropractic Clinic 7222 Edgemont Blvd. N.W. World Health Club Calgary, AB. T3A 2X7 Phone: (403) 241-1886 Fax: (403) 241-0995 Name: (Family) (First) (Initial) Sex: Male Female
More informationEthnomedical Information on Ubos (Spondias mombin)
Ethnomedical Information on Ubos (Spondias mombin) Part / Location Documented Ethnomedical Uses Type Extract / Route Used For Ref # Bark - Africa Bark and/or leaves used for coughs, fever, constipation,
More informationSupplementary appendix
Supplementary appendix This appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors. Supplement to: Williams CM, Maher CG, Latimer J, et al. Efficacy
More information0301 Anemia Others. Endocrine nutritional and metabolic disorders Others Vascular dementia and unspecified dementia
Certain infectious and parasitic diseases 0101 Intestinal infectious diseases 0102 Tuberculosis 0103 Infections with a predominantly sexual mode of transmission 0104 Viral infections characterized by skin
More informationLAKES INTERNAL MEDICINE
LAKES INTERNAL MEDICINE HEALTH HISTORY QUESTIONNAIRE Please print this and complete and bring to your initial appointment. Today's Date Last Name First Name Middle Initial Date of Birth Male Female Education
More informationHawler Medical University College of Pharmacy Dept. of Pharmacognosy Course Book Pharmacognosy I and II, 3 rd year
Hawler Medical University College of Pharmacy Dept. of Pharmacognosy Course Book Pharmacognosy and, 3 rd year Course Coordinator: Dr. Alaadin M. Naqishbandi Assistant Professor 014-015 Course Coordinator
More informationMedication Allergies
**PLEASE CHECK IN 15 MINUTES PRIOR TO APPOINTMENT WITH FORMS COMPLETED** Primary Provider at Ocotillo Internal Medicine Other Physicians you see: Jonathan Hackenyos, D.O. 1. Cheryl Maurice, M.D. 2. 3.
More informationWhole Health Clinic 6632 S. 191 st Place, Suite E-110; Kent, WA (425) Fax (425)
1 Whole Health Clinic 6632 S. 191 st Place, Suite E-110; Kent, WA 98032 (425) 656-0700 Fax (425) 656-0705 Date: Name: Age: Birth Date: Gender: M F Address: City Zip: Phone: Home Can messages be left for
More informationTABLET CAPSULE( ALL ARE VEGETARIAN CAPSULES)
S.NO PRODUCT INDICATIONS PACKING 1 HEAL HERB 2 BP HERB 3 4 5 6 7 DIABETIC HERB GARLIC CAP CAOSULE) STRESS HERB HAIR HERB CARDIAC HERB TABLET USEFUL IN FRACTURE HEALING, PAIN & SWELLING CAUSED BY SPRAIN
More informationPERSONAL HEALTH INVENTORY
Teresa McCurry, C.N.H.P. Passionate Health, 101 Old Mountain Rd., Powder Springs, GA 30127 Fax: 888 289 2171 PERSONAL HEALTH INVENTORY NAME DATE ADDRESS CITY, STATE, ZIP, COUNTRY HOME PHONE WORK PHONE
More informationRockwood Natural Medicine Clinic
Rockwood Natural Medicine Clinic 9755 N. 90 th St., Suite A-210 Scottsdale, Arizona 85258 480-767-7119 Date: Name: Age: Sex: M F Are you: Married Separated Divorced Widowed Single How did you hear about
More informationCommon Herbs and their Medicinal Uses
Common Herbs their Medicinal Uses Introduction Plants continue to be a major source of medicines, as they have been throughout human history. The populations of developing countries worldwide continue
More informationSymptom Review (page 1) Name Date
v2.4, 2/13 JonathanTreasure.com Botanical Medicine & Cancer Herb Drug Interactions Herbalism 3.0 Symptom Review (page 1) Name Date INSTRUCTIONS Please read each section below carefully and, after each
More informationPATIENT INFORMATION (Please print all information) Date:
320 Lillington Ave Suite 101 Charlotte, NC 28204-3189 Phone: 704.362.4403 Fax: 704.362.4405 Please fill out the following form completely so that we may obtain the necessary information for our files and
More information06/09/2005 Medical history and intake form
Medical history and intake form Please complete this form as accurately as possible - it helps to provide you with the best possible treatment. Address including postcode Contact numbers Home/work/mobile
More informationAlivia Acupuncture Clinic, LLC. Address. City State Zip. . Occupation Employer. Emergency contact Relationship. Primary Care provider Phone
Alivia Acupuncture Clinic, LLC Karla Sourasky Olmos, L. Ac Patient Information Name Age Date of birth Address City State Zip Email Home Phone Work phone Cell Phone Marital Status Single Married Divorced
More informationLOZAR. Composition Each tablet contains Losartan potassium 50 mg.
LOZAR Composition Each tablet contains Losartan potassium 50 mg. Tablets Action Angiotensin II [formed from angiotensin I in a reaction catalyzed by angiotensin converting enzyme (ACE, kininase II)], is
More informationClient Questionnaire. Name: Date: Address: Phone: Height Weight Relationship Status Children: Occupation:
Stirred Water Herbs Client Questionnaire www.stirredwater.com 307 Old S Durham Hwy Acra, NY 12405 518-622-9383 This questionnaire is to help you and I understand your health concerns. If you prefer not
More informationEvaluating Exam Review Book and Guide
Pharmacy Prep Evaluating Exam Review Book and Guide Misbah Biabani, Ph.D Director Toronto Institute of Pharmaceutical Sciences (TIPS) Inc. Toronto, ON M2N 6K7 Pharmacy Prep Professional Exams Preparation
More informationLECOM Health Ophthalmology
Patient Name: Date of Birth: New Patient Questionnaire Your answers will be used by your healthcare provider get an accurate history of your medical conditions and ocular concerns. If you are uncomfortable
More informationNEW GYN PATIENT HISTORY FORM (OB PATIENTS, please DO NOT USE THIS FORM. Thanks.)
NEW GYN PATIENT HISTORY FORM (OB PATIENTS, please DO NOT USE THIS FORM. Thanks.) TODAY'S DATE Your age DATE OF BIRTH YOUR NAME (Last) (First) (M.I.) REFERRED HERE BY YOUR PAST MEDICAL HISTORY (If YOU have
More informationBarbara G. Wells, PharmD, FASHP, FCCP, BCPP Dean and Professor School of Pharmacy, The University of Mississippi Oxford, Mississippi
Barbara G. Wells, PharmD, FASHP, FCCP, BCPP Dean and Professor School of Pharmacy, The University of Mississippi Oxford, Mississippi Joseph T. DiPiro, PharmD, FCCP Panoz Professor of Pharmacy, College
More informationNutrition Consultation Intake Form Please write or print clearly
Artemis in the City, LLC Danielle Heard, MS, MS, HHC Clinical & Functional Nutritionist ph: 866-330-5421 fx: 212-535-3234 www.artemisinthecity.com Nutrition Consultation Intake Form Please write or print
More informationANY FAMILY HISTORY OF ANEURYSM OR DVT?
NAME: D/O/B: DATE: MR# WHAT PROBLEM(S) BRINGS YOU HERE TODAY? WHO SENT YOU TO US? DOCTOR/OTHER WHICH DOCTOR? WHAT SURGERY HAVE YOU HAD AND WHEN? (LIST) 1. 2. 3. 4. 5. 6. 7. HOW MUCH ALCOHOL DO YOU DRINK
More informationIntensity: 0-10 (10 is the worse pain you have ever experienced in your life that you would want to jump from a building, 0 is no pain)
Patient Questionnaire: Name: Date: Occupation: Date of Birth: Age: Sex: Male Female Referring Physician: Chief Complaint: Describe your Pain: sudden onset gradual constant intermittent worsening improving
More informationPatient s name Patient s phone numbers Emergency contact name Emergency contact phone number Relationship to patient
Advocate Condell Wound Healing Center 801 South Milwaukee Ave, West Tower Libertyville, IL 60048 847-990-5670 Patient s name Patient s phone numbers Emergency contact name Emergency contact phone number
More informationTable of Contents: 1. Neurology
Table of Contents: 1. Neurology a.) Alzheimer's Disease b.) Brain Abscess c.) Brain Death d.) Cerebral Vascular Disease e.) Headache f.) Meningitis g.) Multiple Sclerosis h.) Muscular Dystrophy i.) Parkinson's
More informationPatient Health History
Patient Health History This information is very important in your care. Please complete as carefully and accurately as possible. Name: Date: Height: inches Weight: lbs Age: Symptoms: 1. Type of symptoms
More informationPatient Medical History
#3 1810, 8 th Street East, Saskatoon SK S7H0T6 Phone (306) 373-5209 Fax (306) 373 5207 Michelle Kormos, Osteopathy (current study) Patient Medical History Please complete the entire medical history and
More informationSouthwest Service Life Insurance Company
Southwest Service Life Insurance Company UNDERWRITING GUIDE 2/2012 95587v1Proof.indd 1 95587v1Proof.indd 2 95587v1Proof.indd 3 Acne A A A ADD A A A Addison s Disease D A D AIDS, ARC, HIV Infection D D
More informationHealthworks Nutrition Centre. Naturopathic Medical Questionnaire. Name Date of First Visit. Address. Province Postal Code. Telephone # (home) (work)
Healthworks Nutrition Centre Naturopathic Medical Questionnaire PERSONAL INFORMATION Name Date of First Visit Blood type # of Children Address City Province Postal Code Telephone # (home) (work) E-mail
More informationHonduras New Hope Clinic Weekly Reports, August Weekly Report August 3-7, 2015
Honduras New Hope Clinic Weekly Reports, August 2015 Weekly Report August 3-7, 2015 This week we saw a total of 82 patients, 35 of whom were unable to pay because of limited financial This a 32 year old
More informationAROMATIC MEDICINE Integrated Advanced Essential Oil Therapeutics for Common Clinical Conditions. 8 day in class International Advanced Diploma Course
AROMATIC MEDICINE Integrated Advanced Essential Oil Therapeutics for Common Clinical Conditions 8 day in class International Advanced Diploma Course by Mark Webb BSc, MASCC (Australia) MODULE I (Days 1
More informationPatient Interview Form
Page 1 of 5 Patient Interview Form Patient Information First Name: MRN: Last Name: Date Of Birth: Contact Preference Email Telephone call- Work Telephone call - Home Email Please check one as your preferred
More informationHerbal Remedies. The list of ailments and infusions used:
Herbal Remedies. The list of ailments and infusions used: A Aching joints - celery, comfrey, rosemary, St John's Wort Aching muscles - chamomile, ginger, marjoram, rose-scented geranium Acidity - chamomile,
More informationLaser Vein Center Thomas Wright MD Page 1 of 4
Demographics Laser Vein Center Thomas Wright MD Page 1 of 4 Patient Name: Address: City, St, Zip Primary Phone: Alternate: DOB: Social Security #: Insurance Information Primary Insurance ID# Group# Subscriber
More informationPharmacology for the Health Care Professions
Pharmacology for the Health Care Professions Christine M. Thorp University of Salford, UK )WILEY-BLACKWELL A John Wiley & Sons, Ltd., Publication Contents Foreword Preface Acknowledgements xüi xv xvii
More informationAromatherapist: CLIENT RECORD. Personal Information: Name: D.O.B Occupation: Address: Telephone: Marital Status: Dependents: Doctor: Doctor Informed?
CLIENT RECORD Personal Information: Name: D.O.B Occupation: Address: Telephone: Marital Status: Dependents: Doctor: Doctor Informed? Medical History: What are you doing for your health:(eg Exercise, Diet,
More informationPatient registration
Patient registration Name: DOB: Sex: Date: Who referred you to our office? Other Physicians you see: Occupation: Place of Employment: Marital Status (Please Circle): Single Married Separated Divorced Widowed
More informationSCHNEIDER MEDICAL GROUP, PA History Intake Form (Please Print)
History Intake Form Patient Name: Date of Visit: Briefly State the reason for the visit: Date of Birth: Physician Use Only - History and Present: 1. 2. 3. 4. 5. Page 1 of 10 Review of Symptoms HEAD NO
More informationName Brufen Flu Tablets & Suspension Description For the relief of the symptoms of colds and flu. Active Ingredients:
Name Brufen Flu Tablets & Suspension Description For the relief of the symptoms of colds and flu Active Ingredients: Brufen Flu each tablet (Film-coated) contains: Ibuprofen 200 mg Pseudoephedrine hydrochloride
More informationChapter 32 Caring for the Elderly Client
Chapter 32 Caring for the Elderly Client Physiological Changes and Adaptations Terms: ego integrity vs despair, gerontology, health conditions Activity and exercise Blood and lymphatic system Slight thickening
More informationDHATU ASSESSMENT. Total the number of symptoms for each tissue category. 1. BLOOD PLASMA (RASA). The clear, serum portion of the blood.
DHATU ASSESSMENT Total the number of symptoms for each tissue category. 1. BLOOD PLASMA (RASA). The clear, serum portion of the blood. Excessively dry skin Dehydration Premature graying of the hair Cold
More informationRHEUMATOLOGY PATIENT HISTORY FORM
!! RAMOS RHEUMATOLOGY, PC RHEUMATOLOGY PATIENT HISTORY FORM Date: / / NAME: Birthdate: / / Last First M. I. Age: Sex: F M Marital status: Never married Married Divorced Separated Widowed Partnered/significant
More informationPocket Guide to Herbal Medicine
Pocket Guide to Herbal Medicine Bearbeitet von Karin Kraft, Christopher Hobbs 1. Auflage 0. Taschenbuch. S. Paperback ISBN 1 1 Format (B x L): x 1 cm Weitere Fachgebiete > Medizin > Komplementäre Medizin,
More informationActive-Med Health and Wellness Centre Leslie St, Unit 7 Richmond Hill, ON L4S0B City Province Apt # Postal Code. Name.
Active-Med Health and Wellness Centre 10650 Leslie St, Unit 7 Richmond Hill, ON L4S0B9 905-237-2012 Patient Intake Form Name (Last, First Middle) Date (DD/MM/YYYY) Date of Birth (DD/MM/YYYY) Preferred
More informationCUMULATIVE ILLNESS RATING SCALE (CIRS)
CUMULATIVE ILLNESS RATING SCALE (CIRS) The CIRS used in this protocol is designed to provide an assessment of recurrent or ongoing chronic comorbid conditions, classified by 14 organ systems. Using the
More informationEthnomedical Information on Embauba (Cecropia obtusifolia)
Ethnomedical Information on Embauba (Cecropia obtusifolia) Part / Location Documented Ethnomedical Uses Type Extract / Route Used For Ref # Inflorescence Amazonia Used for sores of the tongue and mouth.
More informationSURGERY SPECIALTY PATIENT HEALTH HISTORY
SURGERY SPECIALTY PATIENT HEALTH HISTORY Chief Complaint - Please describe the problem that brings you into the office today: Allergies 1. Do you have any allergies? if so, please list To Medications?
More informationMenoChat. City State Zip Code. Employer Job Title. Primary Care Provider Phone: History. Desired Outcome:
MenoChat Patient Health History Questionnaire Patient Name (last, first, MI): How did you hear of MenoChat? Address City State Zip Code Home Phone #: Cell Phone #: Male or Female Marital Status Email Employer
More informationPublic Dissemination Effective: January 2018
Board of Pharmacy Specialties Board Certified Geriatric Pharmacist (BCGP) Detailed Content Outline 1. GENERAL PRINCIPLES OF AGING (20%) A. Apply the knowledge of physiologic changes associated with aging
More informationUniversity Gynecologic Oncology Associates
University Gynecologic Oncology Associates Medical History Form Date: Name: Date of Birth: / / GYNE HISTORY Age of first period? If you no longer have periods, at what age did they stop? Are you pregnant
More informationWELLNESS HISTORY. Patient s Name: Date
u:\share\sr dr\wellness history1 08-08-13 1 WELLNESS HISTORY Patient s Name: Date 1) Have you ever been to Acupuncturist? Yes No If Yes: Currently In the past, When: Did it help? What treatment did you
More informationHolistic Health Care New Patient Intake Form
Holistic Health Care New Patient Intake Form Name * Address * Telephone number: * Email Address * May we use your email address occasionally for health related information? * Are you a current or past
More informationWhat do you believe is causing your most important health concern?
Intake form Name Today s Date Date of Birth Address City Phone Postal Code Email Primary Health Care Provider Emergency Contact Phone Note: By providing your email address you are giving us consent to
More informationDOB: / / Please list the names and telephone numbers of the other physicians involved in your care: Name Specialty Phone Address Receive Report (Y/N)
Medical History: Patient: DOB: / / Please list the names and telephone numbers of the other physicians involved in your care: Name Specialty Phone Address Receive Report (Y/N) List the names of prescription
More information