His Holiness
Maharishi
Mahesh Yogi
  
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Physical sensations

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 Physical sensations and its symptoms.
Stress-related caused by Physical sensations Stress-related Diet-related caused by Physical sensations Diet-related
Neuropathy caused by Physical sensations Neuropathy Multiple sclerosis caused by Physical sensations Multiple sclerosis
Parkinson's disease caused by Physical sensations Parkinson's disease Paresthesia caused by Physical sensations Paresthesia
Poor circulation caused by Physical sensations Poor circulation Poor posture caused by Physical sensations Poor posture
From sitting too long caused by Physical sensations From sitting too long None caused by Physical sensations None
2) (required) Check one or more primary areas to be addressed.
  Left Head and/or neck influenced by Physical sensationsLeft Head and/or neck    
  Right Head and/or neck influenced by Physical sensationsRight Head and/or neck    
  Left Upper extremities influenced by Physical sensationsLeft Upper extremities    
  Right Upper extremities influenced by Physical sensationsRight Upper extremities    
  Left Lower extremities influenced by Physical sensationsLeft Lower extremities    
  Right Lower extremities influenced by Physical sensationsRight Lower extremities    
  Left Torso influenced by Physical sensationsLeft Torso    
  Right Torso influenced by Physical sensationsRight Torso    
3) (required) Check one or more Sensations that are predominant in your case of Physical sensations.
  Shakiness caused by Physical sensationsShakiness   Itching caused by Physical sensationsItching   Numbness caused by Physical sensationsNumbness   Heaviness caused by Physical sensationsHeaviness   Weakness caused by Physical sensationsWeakness   Rawness caused by Physical sensationsRawness
  Pain caused by Physical sensationsPain   Stiffness, rigidity and/or tightness caused by Physical sensationsStiffness, rigidity and/or tightness   Burning caused by Physical sensationsBurning   Heat caused by Physical sensationsHeat   Prickling caused by Physical sensationsPrickling
  None caused by Physical sensationsNone
4) Check one or more kinds of Pain that you experience in association with your case of Physical sensations or its symptoms.
  Sharp pain caused by Physical sensationsSharp   Dull/Achey pain caused by Physical sensationsDull/Achey   Burning pain caused by Physical sensationsBurning   Prickling pain caused by Physical sensationsPrickling   Stabbing pain caused by Physical sensationsStabbing   Shooting pain caused by Physical sensationsShooting
  Unbearable pain caused by Physical sensationsUnbearable   Constant pain caused by Physical sensationsConstant   Occasional pain caused by Physical sensationsOccasional   Intermittent pain caused by Physical sensationsIntermittent   Acute pain caused by Physical sensationsAcute   Extreme pain caused by Physical sensationsExtreme
  Throbbing pain caused by Physical sensationsThrobbing
Current condition
5) (required) Select how often you experience Physical sensations or its symptoms.
Frequency of Physical sensations
6) (required) Currently, how severe is your case of Physical sensations or its associated symptoms?
Duration of Physical sensations     mild     moderate     severe     very severe
7) (required) How disabling is your case Physical sensations or its symptoms?
Disablity from Physical sensations  mildly  moderately  severely  very severely  Not at all
Disorder History
8) (required) Approximately, how long have you had Physical sensations or its symptoms?
Duration of Physical sensations  years  months  weeks
9) (required) Is your case of Physical sensations the result of an accident or another sudden traumatic event?
Physical sensations from accident yes  no  unsure
10) (required) Has your case of Physical sensations been medically diagnosed?
Physical sensations was medically diagnosed yes  no
11) Brief history of your case of Physical sensations and its treatment  (optional - up to 250 characters only) 
History of Physical sensations
12) How many prior 3-session Maharishi Vedic Vibration Technology consultations have you had for Physical sensations?
Prior MVVT treatments for Physical sensations  0  1  2  3  4 or more
12) What was the average percentage of relief you gained as a result?
Percent improvemnt through Physical sensations  75-100%  50-75%  25-50%  0-25%  Unsure
Comments
13) Additional comments (up to 250 characters only)
Comments about Physical sensations

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