Friday, May 30, 2014

For Direct Consultation Please visit

For Direct Consultation Please visit

Chennai - 
(Consultation by Appointment only)
Vivekanantha Homeo Clinic & Psychological Counseling Center
B-12, Second Floor, Paramount Park (Dr Plaza) - B Block,
Velachery Main Road,
Direct Opposite to Saravana Stores, Mega mart upstairs,

Near Vijaya nagar Bus Stand,Velachery, Chennai 42,

Panruti – 
Vivekanantha Homoeo clinic & Psychological Counseling Center
126,Chennai Salai
( Near Railway Gate, Lakshmi Villas Bank ATM Direct Opposite)
Panruti 607106
Cuddalore District

For Appointment
Please call: 09443054168, 09786901830

Pondicherry Camp
(Consultation by Appointment only)
Every Saturday:11.00am to 04.00pm

Ø  We are takingonly minimum number of patients per day.
Ø  We are allotting 40 to 5o minutes for new patients & 15 to 20 minutes for follow-ups.
Ø  So be thereat time to avoid unwanted waiting
Ø  For Psychological consultation“we concentrate more to client’s privacy, so we are allotting 40 to 50 minutes/client – so be there at time”

For Appointment
Please call: 09443054168, 09786901830

For Foreign patients
For more detail and mode of payment
Send mail to
Call +91 9443054168, +91 9786901830

Professional secrecy will be maintained
(Your complaints and other Details should be kept very confidential)


Please Contact for Appointment



Please answer this questionnaire in as great detail as possible and send it to our email for our analysis and evaluation. After the analysis we will get back to you regarding your case.





Marital status:



Phone numbers*:

Follow the instructions.

1) List out all your complaints. (Example headache, fever, diarrhoea, vomiting etc)

2) Kindly give a detailed description regarding each compliant

(some hints: i.e. what is your exact difficulty, what make you approach the doctor, what is the probable cause for the starting of the complaint ,since when is it present, is it increasing in severity or stand still or coming and going , what is the time in which your compliant is worsening or reducing, what make you give relief of the complaint , are there any associated symptoms with this complaint, is it related to the weather changes, change in diet, regarding the pain – the type of pain , where is it originating , where does it extend to . )

A) Kindly furnish details of your past illness and vaccinations (Past History)

b) Kindly furnish details if illness suffered by your father, mother, siblings, grand parents, Maternal & Paternal Aunts and uncles,


(a) Give details regarding your appetite, thirst, sleep, bowels, urine, Sweat

(b) Are there any specific desires and aversions in your diet?

(e.g.: sweets, sour foods, salty foods, etc.)

(c) Are you allergic or sensitive to any foods / articles / any other things?

(d) What kind of weather are you most comfortable in? / What is your reaction or tolerance to the different types of climate? (Summers, humid weather, winter)

(e) Are you particularly uncomfortable in any weather or climate?

(f) What about your dreams?

(g) Give details about your routine activities? Your schedule of the day? Give details about your behavioural patters, reactions to situations, your inner feelings, etc

Additional Information (if any)
kindly send the scanned copies of any previous Medical reports- blood, x-ray, MRI, CT scan


1-Age at onset of periods (menarche)?

2-Details of menstrual Periods? (Regular/Irregular),

Dates of last menstrual periods,

3-Details regarding the flow,



Associated symptoms,

Any discharges,

Are you using any contraceptive pills? Yes No

Any complaint before, during or after the menses?

Details of previous Abortions / pregnancies?

Number of children and whether the deliveries were normal?

Any post-delivery problems? Were the children breastfed or not?

Any problems during the breastfeeding phase?

Age of onset of menopause?

Did the periods cease gradually or abruptly? Gradually/ Abruptly

Have you had any operations done in the pelvic area? Give details

Additional information

Children’s (age, sex):

Skin colour:

Colour of nail:

Hair (colour, falling, thin/thick, split, dry/shiny etc…):




Face (oily/dry/combo):

If any other:

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