HART & SOL INTEGRATIVE HEALTHCARE - (289)271-2788
  • Home
  • BOOK ONLINE!
  • Masking & Safety Policy
  • OUR TEAM
    • DR. FIGUEROA ND
    • DR. LETOURNEAU ND
    • DR. MACKIMMIE RN ND
    • AMY RIDDICK, Physiotherapist
    • TANA THOMPSON, Registered Massage Therapist
  • Services
    • Naturopathic Medicine
    • Fertility Check-Up Program
    • Fertility Enhancement Program
    • Intravenous Therapy "Vitamin Drip"
    • Tests
    • Physiotherapy
    • Registered Massage Therapy
    • Thermography
  • Patient Forms
    • Naturopathic Adult Intake Form
    • Women's health & fertility questionnaire
    • Naturopathic Child Intake Form
    • Naturopathic Informed Consent Form
    • Insurance Claim Consent Form
    • IV Therapy Consent Form
  • Conditions We Treat
  • Service Fees
  • Nutritional Supplements
  • Contact & Hours
  • Niagara Natural Fertility

​WOMEN'S HEALTH AND FERTILITY QUESTIONNAIRE

If you are unsure if you have any of the symptoms listed below, leave the checkbox blank. You will be required to note how your tongue appears. VERY IMPORTANT: stick your tongue out while looking in a mirror UPON RISING before drinking, eating, or brushing your teeth, and note the appearance of your tongue. Colour? Thick? Thin? Coating? Cracks? Teeth marks?
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Opening Hours

Monday - Friday: 10 am to 6 pm
Holidays: Closed

Contact

Address: 4161 Portage Rd. Niagara Falls
Tel: (289) 271-2788
Fax: (289) 723-0188

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©2023 Copyright Hart & Sol Integrative Healthcare
  • Home
  • BOOK ONLINE!
  • Masking & Safety Policy
  • OUR TEAM
    • DR. FIGUEROA ND
    • DR. LETOURNEAU ND
    • DR. MACKIMMIE RN ND
    • AMY RIDDICK, Physiotherapist
    • TANA THOMPSON, Registered Massage Therapist
  • Services
    • Naturopathic Medicine
    • Fertility Check-Up Program
    • Fertility Enhancement Program
    • Intravenous Therapy "Vitamin Drip"
    • Tests
    • Physiotherapy
    • Registered Massage Therapy
    • Thermography
  • Patient Forms
    • Naturopathic Adult Intake Form
    • Women's health & fertility questionnaire
    • Naturopathic Child Intake Form
    • Naturopathic Informed Consent Form
    • Insurance Claim Consent Form
    • IV Therapy Consent Form
  • Conditions We Treat
  • Service Fees
  • Nutritional Supplements
  • Contact & Hours
  • Niagara Natural Fertility