Foundational Assessment | Intake form

In Ayurveda, everything counts: your metabolic tendencies, your daily habits, what you eat, your medical history, your environment… In short, YOU as a whole.

This questionnaire will take 15–20 minutes of your time, but it will make all the difference for our appointment. The more details you give me now, the more we can focus on what truly matters to you during our live conversation.

We are a team in your health journey. The accuracy of your answers allows me to offer you personalised and relevant advice right from your first consultation. Take your time, be honest. The more you invest now, the better I can support you effectively.

You can save your answers and complete and send the form at a later time, if you wish. If you prefer, you can instead download this intake questionnaire in PDF form, and send it back to me by e-mail.

Formulaire d'accueil - Evaluation complète EN (#34)

1. Personal information


🤳Online consultation

If this consultation takes place remotely, please send me the following recent photos. These photos are traditional observational elements in Ayurveda and allow me to compensate for the limitations of observation during a video consultation.


Full-body photos