His Holiness
Maharishi
Mahesh Yogi
 
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Palpitations

Your answers will enable us to develop your personalized consultation.
Select the consultation type for this disorder. For more information, click on the consultation type.
   Enhanced ($900)

   Additional or Follow-up ($450)
Issues
1) (required) Check one or more characteristics or information relevant to your current case of Palpitations and its symptoms.
Irregular heart beat caused by Palpitations Irregular heart beat Tachycardia (rapid heart beat) caused by Palpitations Tachycardia (rapid heart beat)
Fluttering caused by Palpitations Fluttering Associated with anxiety, anger or stress caused by Palpitations Associated with anxiety, anger or stress
Poor circulation caused by Palpitations Poor circulation Cold extremities caused by Palpitations Cold extremities
Mitral valve prolapse caused by Palpitations Mitral valve prolapse Atrial fibrillation caused by Palpitations Atrial fibrillation
Weak heart beat caused by Palpitations Weak heart beat Gas or heartburn caused by Palpitations Gas or heartburn
Chest pain caused by Palpitations Chest pain Heart murmur caused by Palpitations Heart murmur
Heart failure caused by Palpitations Heart failure Heart attack caused by Palpitations Heart attack
Sedentary caused by Palpitations Sedentary Overweight caused by Palpitations Overweight
Blocked energy flow caused by Palpitations Blocked energy flow None caused by Palpitations None
2) (required) Check one or more primary areas to be addressed.
  Heart influenced by PalpitationsHeart
  Left Chest  influenced by PalpitationsLeft Chest
  Right Chest  influenced by PalpitationsRight Chest
  Center Chest  influenced by PalpitationsCenter Chest
  Left Back  influenced by PalpitationsLeft Back
  Right Back  influenced by PalpitationsRight Back
  Center Back  influenced by PalpitationsCenter Back
3) (required) Check one or more Sensations that are predominant in your case of Palpitations.
  Shakiness caused by PalpitationsShakiness   Itching caused by PalpitationsItching   Numbness caused by PalpitationsNumbness   Heaviness caused by PalpitationsHeaviness   Weakness caused by PalpitationsWeakness   Rawness caused by PalpitationsRawness
  Pain caused by PalpitationsPain   Stiffness, rigidity and/or tightness caused by PalpitationsStiffness, rigidity and/or tightness   Burning caused by PalpitationsBurning   Heat caused by PalpitationsHeat   None caused by PalpitationsNone
4) Check one or more kinds of Pain that you experience in association with your case of Palpitations or its symptoms.
  Sharp pain caused by PalpitationsSharp   Dull/Achey pain caused by PalpitationsDull/Achey   Burning pain caused by PalpitationsBurning   Prickling pain caused by PalpitationsPrickling   Stabbing pain caused by PalpitationsStabbing   Shooting pain caused by PalpitationsShooting
  Unbearable pain caused by PalpitationsUnbearable   Constant pain caused by PalpitationsConstant   Occasional pain caused by PalpitationsOccasional   Intermittent pain caused by PalpitationsIntermittent   Acute pain caused by PalpitationsAcute   Extreme pain caused by PalpitationsExtreme
Current condition
5) (required) Select how often you experience Palpitations or its symptoms.
Frequency of Palpitations
6) (required) Currently, how severe is your case of Palpitations or its associated symptoms?
Duration of Palpitations     mild     moderate     severe     very severe
7) (required) How disabling is your case Palpitations or its symptoms?
Disablity from Palpitations  mildly  moderately  severely  very severely  Not at all
Disorder History
8) (required) Approximately, how long have you had Palpitations or its symptoms?
Duration of Palpitations  years  months  weeks
9) (required) Is your case of Palpitations the result of an accident or another sudden traumatic event?
Palpitations from accident yes  no  unsure
10) (required) Has your case of Palpitations been medically diagnosed?
Palpitations was medically diagnosed yes  no
11) Brief history of your case of Palpitations and its treatment  (optional - up to 250 characters only) 
History of Palpitations
12) How many prior 3-session Maharishi Vedic Vibration Technology consultations have you had for Palpitations?
Prior MVVT treatments for Palpitations  0  1  2  3  4 or more
12) What was the average percentage of relief you gained as a result?
Percent improvemnt through Palpitations  75-100%  50-75%  25-50%  0-25%  Unsure
Comments
13) Additional comments (up to 250 characters only)
Comments about Palpitations

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