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  • Fertility, IVF, Pregnancy & Postpartum Herbal Consultation – Health ConnectShen

    Please provide your personal details, health history, and current concerns to help us tailor your herbal treatment plan. Please allow approximately 15–30 minutes to complete this consultation form. The information provided helps us prescribe safe and effective herbal medicine and provide personalised healthcare recommendations. Senior Practitioner- Dr Nicky Macdonald (Chinese Medicine) and Dr Natalie Westwood (Chinese Medicine). Website: www.healthconnectshen.com.au. Phone: 0409 230 261.
  • What best describes your consultation pathway?*
  • Ovulation Tracking Method
  • PMS and Menstrual Symptoms (select all that apply)
  • Have you been diagnosed with any of the following?
  • Fertility Investigations Completed
  • How would you describe your stress levels?
  • How would you rate your sleep quality?
  • How would you describe your overall energy?
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  • Upload a File
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  • Treatment commitment statement
  • Herbal safety wording for pregnancy and breastfeeding
  • Current pregnancy status
  • Due date
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  • Baby's birth date
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  • Breastfeeding status
  • Date of Birth*
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  • Format: (000) 000-0000.
  • Partner's Date of Birth
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If you have any questions with your purchase, please email: connect@healthconnectshen.com.au