& A Health Consultation With Naturopath Patrick Hamouy

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About
- Patrick Hamouy
- Patrick Studies
Contact

Laurence is a gifted Filipino Psychic SurgeRubelyn Hamouychic surgeon. He has helped tens of thousands regain health.

I cured myself of lI'ver and large intestines cancer, and you can do it too.

Prostate consultation form

This form is only for prostate consultations.

If you have not done so yet, you may book this consultation here.

Consultations for other health problems may be booked here.

This Form cannot be submitted until the missing
fields (labelled below in red) have been filled in

Please note that all fields followed by an asterisk must be filled in.

First Name*

Last Name*

Email address*

Country*

Nearest Big City To You*

Date of Birth*

Specify which to use for the consultation + your id: Skype or WhatsApp or Messenger*

How long have you suffered from your prostate problems?*

Describe your symptoms*

What medication(s) are you taking?*

What vitamins/ herbs are you taking?*

Do you exercise? Which and how often?*

Do you eat any organic foods? Which and how often?**

I eat chicken*

	6 or more times a week
	3 to 5 times a week
	1 to 2 times a week
	Never

I eat pork or beef*

	6 or more times a week
	3 to 5 times a week
	1 to 2 times a week
	Never

Other meat you eat*

I eat gluten? .. bread, cakes, biscuits, flour products, etc..*

	6 or more times a week
	3 to 5 times a week
	1 to 2 times a week
	Never

I eat dairy products from cow, goat, sheep, etc..*

	6 or more times a week
	3 to 5 times a week
	1 to 2 times a week
	Never

I eat tropical fruits (oranges, bananas, kiwi, mangoes, etc..)*

	6 or more times a week
	3 to 5 times a week
	1 to 2 times a week
	Never

I eat tin food or pre-prepared meals*

	Yes
	No

I always check products labels to make sure I don't eat sugar*

	Yes
	No

I always check labels to make sure I don't eat any harmful chemicals (additives, coloring, etc..)*

	Yes
	No

I smoke*

	Yes
	No

I drink alcohol*

	6 or more times a week
	3 to 5 times a week
	1 to 2 times a week
	Never

Other Comments

How did you hear about my consultation?*

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