AL-HAKIM Homeopathic Center Richmond Hill, Ontario,Canada

Virtual Online Homeopath Consultation

Book Your Virtual Consultation Online

✅ Choose your preferred time slot
✅ Connect via Zoom or WhatsApp
✅ Secure your appointment with easy online payment

📅 Book at your convenience — hassle-free and flexible!

First Initial Consultation ( Virtual )

Patient must submit their initial intake form and patient consent form prior to Visit. The Intake forms available online are mainly about their past medical history and current related health issues in details the patient is currently experiencing. The First Initial Visit may take up to two hours for assessing the patient to describe in detail about his/her mental, emotional and physical symptoms. We do follow all parameters to assured that all the provided information is safe & held confidential. It is important that patients are able to express themselves in the deepest possible describing the totality of symptoms will allow us to determine the best suitable remedy in combination of all mental, physical & diet suggestions.

Follow Up Visits ( Virtual )

The patient must return for a follow-up appointment(s) as instructed may be in a week by the Homeopath. This appointment usually takes about an hour or Less depending upon the disease. After taking the remedy, the patient must record all the changes or effects he/she has noticed after taking the medication as directed. These parameters will be re assessed by Homeopath. Depending on the homeopath’s assessment, the patient may just wait and observe further as the remedy is still working in him/her maybe given the same remedy with the same or different potency or may need additional remedy.

Please Fill the Intake & Consent form

Legal Disclaimer

Our Clinic or Homeopaths do not claim to cure any disease which is considered “Incurable” on the basis of scientific facts by modern medicine. The website’s content is not a substitute for direct, personal, professional medical care and diagnosis. None of the medicines mentioned including services, should not be used without clearance from your physician or healthcare provider.  All verbal conversation or suggestion cannot be claimed as prescription.

If you wish to reschedule or rebook your appointment, please call us at least 24 hours in advance. For cancellations made with less than 24 hours’ notice, a $35 cancellation fee will apply.

Intake Form

Instructions

You have come here to get well. In order to do that we depend on your information & cooperation.
HOMOEOPATHIC MEDICINE IS MAINLY SELECTED ON THE SYMPTOMS YOU GIVE US. If we are to make a successful prescription, we must know all the details of your sickness. We must also understand all the features that belong to you as an individual. This includes your reactions to various factors, your past and family history and your mental makeup. This information enables us to select the remedy that removes your sickness. The medicine also makes you well as a whole person.
In order find all about you, we shall be asking you many questions. Each one of these questions has a definite meaning and significance for us. There is not a single question that is useless. Even something that you may think is not connected with your trouble may be the most important factor in deciding the correct homoeopathic medicine. That is why you must be free and frank and give us the fullest possible information on each point. Please read each question carefully, think, and if necessary, consult someone close to you and then answer completely. Do not keep anything back. Remember, whatever you tell us will remain absolutely confidential. .

This questionnaire has 8 parts:

  1. About your past illnesses.
  2. History of your present illness.
  3. About all the parts of your body.
  4. Factors that affect your health.
  5. About your mental and emotional state.
  6. About your sleep and dreams.
  7. For children or how you were as a child.
  8. Instructions for reporting your complaints.

Please take time to answer each question carefully before coming to us.

CONFIDENTIAL INFORMATION

Every disease, poisoning, drug or accident leaves its mark and remains as a weak point in the system, much more than we imagine. Homeopathic treatment takes into account all these details of the past and thus removes all the weak points.

Thus your body is strengthened. It is necessary for us to know about all the ailments you have suffered from in the past and the treatments you have taken. In the list below, circle or tick the names of ALL major illnesses you have suffered so far and on the next page give relevant details.

Questions about your birth

Indicate number of times you were vaccinated for the following :

Your Habits How much

Main Present Complaints and Troubles

APPETITE AND THIRST

ANY COMPLAINTS ABOUT

STOOL

URINATION & URINE

SWEAT / PERSPIRATION - FEVER - CHILL

CHEST - HEAT - COLD - COUGH

SEXUAL SPHERE ( GENERAL )

Questions For Men

Questions For Women

CONSENT FORM FOR HOMEOPATHIC ASSESSMENT and TREATMENT

*Witness signature is advised but not required

REFUSAL OF CONSENT

*Witness signature is advised but not required

Attach your Medical Diagnostics