Acupuncture Treatments for Stress Relief | Chinese Herbal Remedies Supplement Acupuncture

Fill Out the Stress Survey Below and
Receive an Initial Evaluation at $20 (a $250 Value)

Please fill out the following survey. Upon completion click the "Submit My Stress Survey!" button. Acupuncture & Holistic Health Associates of Milwaukee will keep your information in strict confidence. This survey will be used only to help our Milwaukee holistic healing experts determine the causes of your health problems getting you on the Milwaukee highway to a healthier, happier and more balanced you.

STRESS SURVEY (FILL IN BELOW)

Holistic Acupuncture provides help with stress in Milwaukee, Wisconsin using acupuncture care.

PURPOSE:
To determine if any health problems you may be having are due to stress.

All information is kept in strict confidence and we never share or give out your information.

Please fill out the following information and click the "Submit My Stress Survey!" button at the bottom of the form when done:

STRESS SURVEY

Name:		Age:		Phone(H):		Phone(W):
Address:		City:		State:		Zip Code:

Occupation:		# Hours per week currently working:
Spouse's occupation:		# Hours per week currently working:
Email Address:

1. Check off any of the following symptoms you have experienced in the past 6 months:

Headaches/Tension	Low Back Pain	Pain Between Shoulder Blades	Allergies
Headaches/Tension	Low Back Pain	Pain Between Shoulder Blades	Weight Trouble
FatigueTired	Neck Pain	Knee Pain	Shoulder Tension
Pain Anywhere in the body	Wrist/Hand Pain	Ankle/Foot Pain	Numbing in Arms
Digestive Disturbance	Elbow Pain	Ringing in Ears	Numbing in Legs
Insomnia/Sleep Problems	Shoulder Pain	Nervousness	Other:
Irritability	Hip Pain	Dizziness

Which of the above bothers you the most?

How long have you been bothered by the condition?

Describe how it feels or affects you when it is at its worst:

2. Does this cause you to be:

Moody Irritable Interrupt Sleep Restricted on Daily Activities

3. Does this affect your work:

Decision Making	Poor Attitude	Decreased Productivity
Exhausted at End of Day	Unable to Work Long Hours

4. Does this affect your life:

Lose Patience with Spouse or Children

Restricted Household Duties

Hinders Ability to Exercise or Participate in Sport

Interferes with Ability to Participate in Hobbies or Other Desired Activities

If you checked any of the above items, your organs are probably not functioning as well as they could, and your energy is probably not flowing as smoothly as it could be.

ACUPUNCTURE and CHINESE HERBAL MEDICINE CAN HELP YOU because they grant and naturally treat the body to remove the stress and imbalance that cause health problems.

Would you like to get rid of the problem? Yes No

If your answer is Yes, there are several alternatives available to you. Please check the item most appropriate for you:

	I would like to come to the Acupuncturist's office for an initial evaluation to see if acupuncture can help me.
	I would like to come for further wellness classes
	I would like the acupuncturist to call me to discuss my health problem before making an appointment.

Stress affects Milwaukee residents in many ways. Is your job performance suffering? Do you rush to and from work with every day seemingly ending in complete fatigue? If you wake up feeling un-rested or can’t sleep due to chronic allergies consider; stress is proven to increase blood pressure, contributes to un-restful sleep, causes fatigue and many serious health problems even leading to depression if not managed.

It could be as simple as frustration over the horrible traffic commuting to work in Milwaukee or a low level irritation of a tennis or softball injury that just won’t completely go away or the nagging irritation of lower back pain brought on my snow shoveling or seasonal Wisconsin yard work.

If your problems are stress related the team at Acupuncture & Holistic Health Associates of Milwaukee will relieve your stress with comparatively un-invasive, drug free acupuncture treatment. Acupuncture helps to relieve pain through the release of endorphins. Acupuncture has been found to increase T-cells aiding in the reduction/elimination of allergy symptoms and chronic fatigue in many patients.

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