His Holiness
Maharishi
Mahesh Yogi
 
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Whole body whiplash with associated trauma

Your answers will enable us to develop your personalized consultation.
Read carefully before proceeding:
Each initial consultation for Whole body whiplash with associated trauma requires 12 sessions. Subsequent consultations for Whole body whiplash with associated trauma may be taken in 3 sessions at the reduced fee. Click here for more information about consultation fees.

(required) Indicate below if this is an initial (12-session) consultation or a repeat (3-session) consultation.
    An initial consultation (12-session)     A repeat consultation (3-session)
Issues
1) (required) Check one or more characteristics or information relevant to your current case of Whole body whiplash with associated trauma and its symptoms.
 Result of automobile accident  Result of other accident
 Chronic back pain  Very tight muscles
 Muscle spasms  Pain after lifting
 Restricted mobility  Inhibits exercise
 Worse during or after exercise  Feels improved during or after exercise
 Confined to bed  Have had surgery to correct the problem
 Have had chiropractic adjustments for the problem  Mobility of neck affected
 Frequent headaches  Tension in neck and shoulders
 Tingling and numbness down arms  General pain and stiffness
 Injury to the pelvis, buttocks and/or coccyx  Sciatica
 Concussion  Blocked energy flow
 None
2) (required) Check one or more primary areas to be addressed.
  Left Neck
  Right Neck
  Left Shoulder
  Right Shoulder
  Left Upper back
  Right Upper back
  Left Mid back
  Right Mid back
  Left Lower back
  Right Lower back
  Left Pelvis
  Right Pelvis
  Left Head
  Right Head
  Front Head
  Back Head
  Top Head
  Left Upper extremities
  Right Upper extremities
  Left Lower extremities
  Right Lower extremities
  Whole body
3) (required) Check one or more Sensations that are predominant in your case of Whole body whiplash with associated trauma.
  Shakiness   Itching   Numbness   Heaviness   Weakness   Rawness
  Pain   Stiffness, rigidity and/or tightness   Burning   Heat   None caused by Whole body whiplash with associated traumaNone
4) Check one or more kinds of Pain that you experience in association with your case of Whole body whiplash with associated trauma or its symptoms.
  Sharp   Dull/Achey   Burning   Prickling   Stabbing   Shooting
  Unbearable   Constant   Occasional   Intermittent   Acute   Extreme
Current condition
5) (required) Select how often you experience Whole body whiplash with associated trauma or its symptoms.
Frequency of Whole body whiplash with associated trauma
6) (required) Currently, how severe is your case of Whole body whiplash with associated trauma or its associated symptoms?
Duration of Whole body whiplash with associated trauma     mild     moderate     severe     very severe
7) (required) How disabling is your case Whole body whiplash with associated trauma or its symptoms?
Disablity from Whole body whiplash with associated trauma  mildly  moderately  severely  very severely  Not at all
Disorder History
8) (required) Approximately, how long have you had Whole body whiplash with associated trauma or its symptoms?
Duration of Whole body whiplash with associated trauma  years  months  weeks
9) (required) Is your case of Whole body whiplash with associated trauma the result of an accident or another sudden traumatic event?
Whole body whiplash with associated trauma from accident yes  no  unsure
10) (required) Has your case of Whole body whiplash with associated trauma been medically diagnosed?
Whole body whiplash with associated trauma was medically diagnosed yes  no
11) Brief history of your case of Whole body whiplash with associated trauma and its treatment  (optional - up to 250 characters only) 
History of Whole body whiplash with associated trauma
12) How many prior 3-session Maharishi Vedic Vibration Technology consultations have you had for Whole body whiplash with associated trauma?
Prior MVVT treatments for Whole body whiplash with associated trauma  0  1  2  3  4 or more
12) What was the average percentage of relief you gained as a result?
Percent improvemnt through Whole body whiplash with associated trauma  75-100%  50-75%  25-50%  0-25%  Unsure
Comments
13) Additional comments (up to 250 characters only)
Comments about Whole body whiplash with associated trauma

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