MEDICAL QUESTIONNAIRE FORMS

Before your initial telehealth interview and diagnostic evaluation, please complete the required forms. You can email them to us at info@curemymigraine.com. Our fees for services are reasonable and non-refundable. No Insurance accepted.  In case of repeated migraine headaches, follow-up treatments are free.  We look forward to helping you on your journey to migraine relief.

Medical Questionnaire Forms

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Family History

Personal History

How often did you need to see a doctor for migraine
Results
Migraine Headaches
How often attacked by Migraine
Quality of Pain
Start point of The Pain
Associated Symptoms
Any Trigger for your Migraine
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Severity of pain
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